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Three Ounces Of Prevention

The practitioner should also:

• check your height, weight, blood pressure and vision.

• perform an electrocardiogram (EKG), a painless procedure to check your heart for irregularities.

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• counsel you on Medicare benefits that may be appropriate for you, such as: flu, pneumonia, and hepatitis B shots; mammograms; screenings for diabetes, glaucoma, cardiovascular disease and prostate and colorectal cancer; diabetes outpatient self-management training services; and bone mass measurements.

Why is this exam important? Some people pooh-pooh checkups, but you can spot lots of things in a thorough physical that you just won't find in a short visit, said gerontologist Joanne Crantz of Novamed Associates in Fairfax. She actually would like to see seniors get this type of checkup every year: "I call it the 'strip search' physical. It's amazing how many elderly people have never even been undressed in front of their doctors." Just recently Crantz found a large breast mass in a woman in her mid-sixties during a physical. Another woman's EKG showed heart problems that required bypass surgery.

While listening with her stethoscope during physicals, Crantz has picked up the murmurs of abdominal aortic aneurysms (bulges in blood vessels that can rupture) and the whooshing "bruits" (abnormal sounds) that indicate fatty buildup in the carotid artery, which brings blood to the head.

Crantz said a thorough physical gives the doctor time to really talk to the patient and reflect on the answers. Some patients, she said, don't like to complain: "a little shortness of breath" described by one person was actually a sign of congestive heart failure. Others might be having difficulties with depression or memory loss that they won't mention without prompting. Odds are, the doctor's not going to pick up on everything if she only sees you when you come in for a sinus infection. "A little prevention goes a long way," said Crantz.

Cardiovascular screening blood tests

Who qualifies? All Part B Medicare beneficiaries, regardless of when they joined the program.

What's covered? Blood tests that measure total cholesterol, HDL ("good") cholesterol and triglyceride levels.

The tests can be done individually or all together as a "lipid panel." If the triglyceride level is high, the doctor can order a measurement of LDL ("bad") cholesterol as well.

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