What routine bloodwork/exams/vaccines handy does your doctor do, and and reliable reference or references.
August 29, 2022 12:13 PM Subscribe
This question is about routine bloodwork/exams/vaccines. Basically, what are they?
I have the free low-income public heatlhcare in California and before that in Oregon. I go to a clinic. I have always gone to clinics. This means my doctors never last more than a year. They do their rotation and move on. I'm also not good at identifying the key things I need to tell my doctor about. Or if I do, I sometimes say it wrong and they miss the point and dismiss it.
So they do things like give me STI tests even though I tell them I'm confident my risk factor is like zero, and I don't get other basic tests that I need. Then I figure out myself that something is probably an issue and ask for a test and find out that I'm not in normal ranges and so I fix 'em. This has happened repeatedly and consistently, and it just happened yet again. Dr. Google is my primary doctor. I am so frustrated. But you can help!
I would prefer to stay on top of my health rather than wait until something goes critically wrong. Maintenance keeps physical objects in better condition than repair; I can only assume the human body works the same way.
So I have reached the conclusion that I am in charge of knowing this information myself so that I can proactively ask for it in a more methodical and less haphazard way.
What I need is a handy and reliable reference or references that will tell me:
1. What the common blood tests are, and the slightly less common but possibly still relevant for people ages 40+
2. How often they are recommended
3. Other recommended tests for cis women ages 40+ and how often they are recommended (such as bone density)
4. Anti-recommended tests (like how there's less-invasive options than colonoscopies)
5. Comprehensive recommended vaccine schedule, including less common and new vaccine recommendations. I had to really push to get the HPV vaccine (I mean sure maybe my partner will be my only sex partner for the rest of my life, but do I really want to age out of the vaccine and then he gets hit by a bus or something?!)
6. Anything else I'm missing.
I'm interested in both ready-references and tomes. Books and online references. It would be neat if at least one reference said stuff like "recommendations range from starting this test at age X to age Y and repeating the test every N years to Z years because blablabla"
Please note, this is not a human relations question. Right now I am NOT looking for advice on how to talk to my doctors or what to say to them.
Please specify if this is a reference you already use or just something you googled that looks trustworthy (and why).
I have the free low-income public heatlhcare in California and before that in Oregon. I go to a clinic. I have always gone to clinics. This means my doctors never last more than a year. They do their rotation and move on. I'm also not good at identifying the key things I need to tell my doctor about. Or if I do, I sometimes say it wrong and they miss the point and dismiss it.
So they do things like give me STI tests even though I tell them I'm confident my risk factor is like zero, and I don't get other basic tests that I need. Then I figure out myself that something is probably an issue and ask for a test and find out that I'm not in normal ranges and so I fix 'em. This has happened repeatedly and consistently, and it just happened yet again. Dr. Google is my primary doctor. I am so frustrated. But you can help!
I would prefer to stay on top of my health rather than wait until something goes critically wrong. Maintenance keeps physical objects in better condition than repair; I can only assume the human body works the same way.
So I have reached the conclusion that I am in charge of knowing this information myself so that I can proactively ask for it in a more methodical and less haphazard way.
What I need is a handy and reliable reference or references that will tell me:
1. What the common blood tests are, and the slightly less common but possibly still relevant for people ages 40+
2. How often they are recommended
3. Other recommended tests for cis women ages 40+ and how often they are recommended (such as bone density)
4. Anti-recommended tests (like how there's less-invasive options than colonoscopies)
5. Comprehensive recommended vaccine schedule, including less common and new vaccine recommendations. I had to really push to get the HPV vaccine (I mean sure maybe my partner will be my only sex partner for the rest of my life, but do I really want to age out of the vaccine and then he gets hit by a bus or something?!)
6. Anything else I'm missing.
I'm interested in both ready-references and tomes. Books and online references. It would be neat if at least one reference said stuff like "recommendations range from starting this test at age X to age Y and repeating the test every N years to Z years because blablabla"
Please note, this is not a human relations question. Right now I am NOT looking for advice on how to talk to my doctors or what to say to them.
Please specify if this is a reference you already use or just something you googled that looks trustworthy (and why).
On preview, Mr.Know-it-some beat me to it!
The U.S. Preventive Services Task Force is a US Government source I trust a lot (I am a former health sciences librarian). They have a reputation for being evidence-based and slightly less intervention-heavy than some of the other major players.
A really cool thing that you get with a lot (though not all) of the USPSTF recommendations is "Recommendations of Others," which summarizes recommendations from other organizations. You can see it in this article on bone density screening
The USPSTF page links to a rather handy tool that I haven't used before but that I'm currently having fun playing around with, My Healthfinder, which lets you put in your age and sex and get general recommendations. This seems similar to but not exactly the same as the USPSTF recs.
posted by mskyle at 12:44 PM on August 29, 2022 [5 favorites]
The U.S. Preventive Services Task Force is a US Government source I trust a lot (I am a former health sciences librarian). They have a reputation for being evidence-based and slightly less intervention-heavy than some of the other major players.
A really cool thing that you get with a lot (though not all) of the USPSTF recommendations is "Recommendations of Others," which summarizes recommendations from other organizations. You can see it in this article on bone density screening
The USPSTF page links to a rather handy tool that I haven't used before but that I'm currently having fun playing around with, My Healthfinder, which lets you put in your age and sex and get general recommendations. This seems similar to but not exactly the same as the USPSTF recs.
posted by mskyle at 12:44 PM on August 29, 2022 [5 favorites]
Also: Choosing Wisely, which makes evidence-based recommendations aimed at curbing harmful and wasteful overtreatment. If you are skeptical about a test or treatment, they provide information that will, as their slogan says, promote "conversations between patients and clinicians."
posted by Mr.Know-it-some at 12:48 PM on August 29, 2022 [4 favorites]
posted by Mr.Know-it-some at 12:48 PM on August 29, 2022 [4 favorites]
CDC adult immunization schedule. They have a chart with recommendations based on what age you currently are.
posted by gudrun at 12:57 PM on August 29, 2022
posted by gudrun at 12:57 PM on August 29, 2022
Response by poster: These are all on the right track! Thanks! I will reference these resources.
But I feel like it's not quite everything I had hoped to find yet. If you put a 40 year old non-pregnant female into My Healthfinder, it will give you a list of screenings etc. Great! Seems like what I'm looking for. But then if you scroll down to the "ask your doctor if you're at risk for" section, I'll click on heart and stroke for example. There, it says that if you've tested high for cholesterol, blablabla. But nowhere in the My Healthfinder or the U.S. Preventative Task Force app (browser option available) does it suggest a cholesterol check for that demographic.
But then if I go look, according to the CDC even adolescents should be checked for cholesterol because high cholesterol is common and they say there aren't symptoms. I have no idea whether that's a reliable source or not, but since the My Healthfinder example I gave was assuming that you'd have had a cholesterol check, presumably there's a decision tree somewhere for basic blood tests. Where would I find that or something like it?
posted by aniola at 9:11 PM on August 29, 2022
But I feel like it's not quite everything I had hoped to find yet. If you put a 40 year old non-pregnant female into My Healthfinder, it will give you a list of screenings etc. Great! Seems like what I'm looking for. But then if you scroll down to the "ask your doctor if you're at risk for" section, I'll click on heart and stroke for example. There, it says that if you've tested high for cholesterol, blablabla. But nowhere in the My Healthfinder or the U.S. Preventative Task Force app (browser option available) does it suggest a cholesterol check for that demographic.
But then if I go look, according to the CDC even adolescents should be checked for cholesterol because high cholesterol is common and they say there aren't symptoms. I have no idea whether that's a reliable source or not, but since the My Healthfinder example I gave was assuming that you'd have had a cholesterol check, presumably there's a decision tree somewhere for basic blood tests. Where would I find that or something like it?
posted by aniola at 9:11 PM on August 29, 2022
I've lived in three different countries throughout my adult life and each had vastly different approaches to e.g. screening for cervical cancer and for breast cancer, routine assessments, to a degree also vaccinations. That is often due to prevailing risk assessments within specialities, different population characteristics such as prevailing obesity rates and different preferences/priorities in allocating health care resources.
My take away from that was that official guidance is basically still only a considered opinion, with considerations being weighted differently in different countries, not a universally accepted rule. In addition, official guidance is generally aimed at the population, not at you individually with your specific medical history and risk factors. So official guidance is a general framework but there may then be very good reasons why certain tests are not necessary for you specifically or why certain things should be done anyway.
The only people qualified to actually help navigate these person specific factors more consistently would be a good PCP you build a relationship with. As a youngish largely healthy person with limited risk factors we can get away with seeking medical care ad hoc and from whoever is available/accessible. But as we age it become more important to seek regular preventative care, monitor things over time/ assess them in context so continuity of care becomes a lot more important. By all means build your list of data points. But consider investing the time and effort to find a good PCP as well.
posted by koahiatamadl at 11:20 PM on August 29, 2022 [1 favorite]
My take away from that was that official guidance is basically still only a considered opinion, with considerations being weighted differently in different countries, not a universally accepted rule. In addition, official guidance is generally aimed at the population, not at you individually with your specific medical history and risk factors. So official guidance is a general framework but there may then be very good reasons why certain tests are not necessary for you specifically or why certain things should be done anyway.
The only people qualified to actually help navigate these person specific factors more consistently would be a good PCP you build a relationship with. As a youngish largely healthy person with limited risk factors we can get away with seeking medical care ad hoc and from whoever is available/accessible. But as we age it become more important to seek regular preventative care, monitor things over time/ assess them in context so continuity of care becomes a lot more important. By all means build your list of data points. But consider investing the time and effort to find a good PCP as well.
posted by koahiatamadl at 11:20 PM on August 29, 2022 [1 favorite]
Check out Comprehensive Metabolic Panel and complete Blood Count (CBC).
posted by SemiSalt at 4:55 AM on August 30, 2022
posted by SemiSalt at 4:55 AM on August 30, 2022
I the past, I have approached your question about preventive screenings with the addendum "that my insurance agrees are free". So I always look for preventive services on my insurers website. Not knowing your details, I found these lists as links in the Covered California website. They point to healthcare.gov.
Preventive care for Adults
Additional preventive care for Women
posted by CathyG at 6:53 AM on August 30, 2022
Preventive care for Adults
Additional preventive care for Women
posted by CathyG at 6:53 AM on August 30, 2022
This thread is closed to new comments.
The USPTF's recommendations do not always align perfectly with other organizations' recommendations; they tend to be less aggressive about testing. See for example this comparison of mammography recommendations. So you may choose differently.
And your provider may not follow the recommendations. I had to send my doctor three messages, referring to five different published recommendations, including one published by his own institution, before he would stop ordering an unneeded screening test.
posted by Mr.Know-it-some at 12:40 PM on August 29, 2022 [8 favorites]