Friday, January 16, 2009

Two-pronged route to better health

Two-pronged route to better health
Fri, Jan 16, 2009
New Straits Times

By Kasmiah Mustapha

THE next time you are at the doctor's office, be sure to ask about health screening packages.

Today almost every medical centre offers medical packages tailored to an individual's needs, age and gender. Basic health screening includes a complete physical examination, chest x-ray, urine and blood tests, and an electrocardiography (ECG) test.

With a simple blood or urine test, the doctor is able to detect whether you are at risk of kidney problems, cardiovascular diseases and even cancer. The test can also determine if you have a healthy liver or high blood sugar level.

Prevention is better than cure, both in managing our health as well as in reducing the financial burden of treating an affliction.
Treatment for chronic illnesses such as diabetes can be long and costly. To make matters worse, it can lead to other related diseases if diagnosed at a later stage. Early detection is crucial and one of the ways is through frequent health screenings.

Kelana Jaya Medical Centre consultant physician and gastroenterologist Dr Abdul Malik Jamal Buhari says a health screening should be done at least once in a lifetime, if you are not in the high-risk group. Those between 35 and 40 years of age should undergo it once a year or once in two years.

"If you are in the high-risk group, such as having a family history of heart problems or diabetes, do a blood test every three to four months. But even if you are not at risk, it is advisable to have a cholesterol and blood sugar level screening every year.

"If you do not wish to go for the more advanced packages, the basic is good enough to detect these diseases. You can opt for the complete screening later if you feel that you need to know more."

The basic screening test includes a full blood count to detect the level of red and white blood cells, fasting blood glucose and fasting cholesterol levels, liver and kidney functions, and a urine test. A patient can opt for cancer marker tests and a HIV test.

The fasting blood glucose test helps detect if the patient is diabetic. If the blood sugar level is more than seven mmol per litre, than he or she is a diabetic. However if the level is between five and seven mmol per litre, it is considered borderline diabetes, which needs to be monitored.

"The normal blood sugar level is below 5.6 mmol per litre. If the blood test is done randomly, without the person fasting for 10 hours before taking the test, the normal level is 7.8 mmol per litre."

The blood test can also detect cholesterol levels - low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Total cholesterol level should not be more than 5.2 mmol per litre.

"However, we look at LDL and HDL levels individually to detect if the person is at risk. It's best to have low LDL and high HDL."

LDL - also known as "bad" cholesterol - can slowly build up in the inner walls of the arteries and form plaque (a thick, hard deposit that can clog arteries). This condition, known as atherosclerosis, can lead to a heart attack or stroke.

In contrast, the high level of HDL - "good" cholesterol - protects against heart disease. It is believed that HDL removes excess cholesterol from arterial plaque, slowing its build-up.

Dr Abdul Malik says the LDL level should be below 3.4 mmol per litre. For a diabetic, it must be below 2.6 mmol per litre. Those who have both diabetes and heart disease, or have suffered a heart attack, must ensure their LDL level is at or below 1.8 mmol per litre.

The liver function test detects levels of ALT and AST enzymes in the organ. High levels of these enzymes are proof of liver damage likely caused by fatty liver and hepatitis C, among others.

"We are seeing more cases of fatty liver now brought on by obesity, diabetes, hypertension and high cholesterol. The worrying fact is that many may not realise they have problems with the liver as there are no early symptoms and it is hard to detect."

Fatty liver is one of the most common forms of liver disease and is known to lead to critical conditions. If steps are not taken to control the risks, it can lead to cirrhosis, which can be life-threatening.

Dr Abdul Malik says those who have fatty liver may suffer from cirrhosis in the next 10 to 20 years.

"The number of Malaysians who are obese and diabetic is increasing. If they don't take care of their condition, they will eventually have fatty liver."

A blood test can also be done to detect certain types of cancer such as breast, uterus, ovary, liver, pancreas, colon and stomach.

"The test is about 50 to 60 per cent accurate. But you need to discuss it with the doctor if you want it. It is the same with the HIV test. Doctors have to seek permission from the patient. It is unethical to do these tests without a patient's consent."

Some health screening packages include a stress test to assess the condition of the heart. It is also called the treadmill ECG to determine cardiovascular fitness levels and if there is adequate blood flow to the heart during increasing levels of activity while the patient is running on the treadmill.

While health screenings help with early detection and treatment, it is also important that the person changes his lifestyle even if the screening does not detect any abnormalities, says Dr Abdul Malik.

"Exercise and eating healthily are important to better health management," he emphasised.

This story was first published in the New Straits Times on Jan 13, 2009.

No comments: