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Each patient is required to undergo preventive examinations. Regardless of your lifestyle, regular check-ups can prevent many years of treatment and stop the disease at an early stage. What kind of research should you do every year? Rafał Janiszewski, the owner of the Advisory Office, tells about it.
Anna Tłustochowicz: Do you know people who are afraid of preventive examinations? They say: "I prefer not to know, because if I get tested, they'll find something else for me"?
Rafał Janiszewski:Sure you can. A lot of people do just that. I notice it especially in the elderly - older, but he althy, which is worth emphasizing. The young generation of Poles, however, is largely aware of the fact that there are civilization diseases, that the way of eating and the way of life determine our he alth, and that by detecting irregularities early, you can act wisely and efficiently and help your body. On the other hand, in fact, you can often hear from older people that they are "hard material", that they are made of "strong clay", that they never get sick, and their father has never seen a doctor with his eyes and there is nothing to be tested, because - as you said - "they will find something else".
Basic preventive examinations are therefore performed in order tocapture the first signalsnot necessarily that we are somehow seriously ill, but that something like this is just happening in our body things that are worth taking care of.
Today, however, we will encourage people to do prophylaxis.
Yes, because this is research that is simply worth doing. Let us note that even if you referred to older generations of Poles who usually did not use prophylaxis, our lives have changed a lot: the way we eat, how much processed this food is, how many different additives it has, how the environment has changed - here on he thinks of its pollution - and how the pace of life has changed, that is, that we generally live in a rush, run, and stress. Unfortunately, all this is not favorable for our body.
There are several tests that are worth doing to be sure that everything is fine, or to be able to find out that we have neglected something or our body just happened somewhereweaker, and that we can react quickly.
Where should we start?
From morphology. This is a basic test that can be said to determine the condition of our body. It targets the constituent elements of blood: their quantity is important, the shape of some of its elements, e.g. red blood cells, is important. Red blood cells are extremely important to our he alth because they are responsible for the transport of oxygen. Based on the morphology, we can determine not only such issues as weakness of the body, anemia, but also, for example, get information that an inflammatory process is taking place in the body.
But this simple test may also be the first sign of cancer, right?
Especially when talking about blood cancers, for example leukemias.
We should do the morphology at least once a year.
I am talking now about a he althy person who feels good, because if we feel weakness or other ailments, then we consult a doctor. On the other hand, the norm that we should adopt is morphology once a year.
What else is worth testing?
Urine. The second test, which - contrary to appearances - is very important and can give us really valuable information, is the general urine test. Such examinations should be performed by people under 50 at least once every two years, and after "50" - at least once a year.
Why is general urine testing important?
Because we get a lot of information again. First of all, this is, of course, information related to the work of the kidneys, with filtration, which deteriorates over time, but secondly - we also detect the possible presence of protein, glucose or bacteria in the urine and then it is a clear signal about diseases for which we need to. conduct further diagnostics.
Bacteria in urine? What does this mean?
That we have inflammation. Sugar - that we need further diagnosis for diabetes. Finding white blood cells, phosphates, urates in the urine are all extremely valuable information about the general he alth in various areas. Another test that we should perform systematically is glucose. Especially in overweight people who do not follow a regular, orderly diet.
Generally, a person should measure once a year - on an empty stomach! - sugar level, becausediabetes is a disease of civilization , and develops covertly for a long time.
Has no symptoms?
It is asymptomatic and can cause very serious damagethe body. Increased sugar levels, jumps in its level is one of the main causes of kidney damage, the so-called. diabetic nephropathy. And we must be aware that the glomeruli do not have the ability to regenerate! They will not regenerate, so if they are damaged due to high sugar levels, there will be renal failure.
Sounds very scary!
This is an irreversible disease, and the worst part is that it is a latent disease. For this reason, some doctors even say that she is a silent killer. We do not feel that something is wrong at all, while something very dangerous may be happening in the body. Similarly, high sugar levels can damage our eyesight and this is called diabetic retinopathy. Often times, patients do not even realize that their deteriorating vision is caused by high blood sugar levels.
Is it possible to lose your eyesight because of this?
Yes, of course. You can lose your eyesight.
It is also commonly said that diabetes may result in the necessity of amputation.
Yes, but the diabetic foot is a consequence of diabetes that gives symptoms. And I'm still talking about the initial stage …
Irreversible kidney disease can happen to us in the very early stages of diabetes?
Yes, when it is completely imperceptible to us.
What other tests should we do?
It is important to test your creatinine levels. Creatinine is a substance formed as a result of protein metabolism. As our body cleans the blood through the kidneys, measuring creatinine levels is a measure of how well our kidneys are.
Should we also do this test once a year?
If we are he althy and do not feel any discomfort, then yes. In a situation where the creatinine level turns out to be elevated, the first thing you will need to think about is diet modification and, of course, putting yourself under the care of a nephrologist who will decide how often we should do this test.
Is all the research we are discussing today financed by the National He alth Fund?
All these studies are financed by the National He alth Fund. The quickest and easiest way to perform them is to receive a referral from a primary care physician, however, it must be remembered that, in fact, it is the doctor who refers us to these tests, i.e. he or she makes the decisions. On the one hand, we cannot come and request a referral for specific tests, but on the other hand: GPs are very happy when patients who want to have a medical examination come to them.preventive examinations. So I encourage you to report to the GP with our "wish list", and the doctor may even extend it to us with additional tests, but of course you have to reckon with the fact that he will say that we do not need one of these tests .
I would like to point out that almost half a year ago a large prophylactic program "40 plus" was launched, which is largely based on the primary care physician.
What do 40-year-olds get under this program?
Not only for 40-year-olds! Everyone born in 1981 or earlier can sign up for packages for women, men and the common package. The package for women includes biochemical tests:blood count, cholesterol, blood glucose and creatinine measurements, liver tests and urine and feces tests . The package for men includes all these tests, plus a PSA test, i.e. a prostate cancer test. The package, which is common to both men and women, includes blood pressure, weight, circumference, and height measurements to calculate body mass index, BMI, and an assessment of the regularity of the heart rhythm.
Since there is a prostate cancer test, please say: what about cancer prevention?
The prophylactic tests that we have discussed, e.g. morphology, can inform us that the cancer process begins in the body, but regardless of this, the National He alth Fund finances various diagnostic services to identify specific neoplasms, e.g. for women aged 50-69 years of age, free mammography is performed.
How often?
Once every two years, unless we are talking about women from a high-risk group, i.e. if there is such a cancer among family members, then you should get a mammogram for free every year. Cervical cancer prophylaxis is, of course, screening by cytology. Patients can perform them in any gynecology and obstetrics office that has a signed agreement with the National He alth Fund and in the midwife's office in POZ. A general practitioner may also refer his patients to a free-of-charge examination of a specialist doctor.
Polish women should get free cytology every 3 years.
And the prevention of male cancer?
It is absolutely essential, especially in men over 40 years of age, to perform a PSA test. We are talking about a marker that can point us to a neoplastic process in the prostate. Cancer prevention is also financed by the National He alth Fund. You also have to rememberI always remind you that we can go to the oncologist without a referral. If anything bothers us, we can simply go to a specialist who will write us a referral for basic tests in order to exclude or confirm the risk of cancer and possibly diagnose and treat us more deeply.
Expert
Rafał Janiszewski, owner of the Advisory Office providing services in the field of he althcare organization to he althcare entities
Speaker, organizer of many trainings and conferences on he alth protection and patient rights. In the years 1998-1999 an employee of the Office of the Government Plenipotentiary for the Implementation of the General He alth Insurance. Author of over 20 books on he althcare organization and he alth care financing standards. In 2005-2007, he was an expert of the Presidium of the Parliamentary He alth Committee, as an advisor on he alth services. Co-author of the general study as part of the Pharmaceutical Pricing and Reimbursement project for the European He alth Commission.
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