40-Year-Old Guys: An Easy Trip To The Doctor yields a Solid ROI.

Evidenced-based suggestions to help you get the most out of the preventative visit you might be reluctant to make.

You’re 40. Friends are probably ribbing you a bit about your advanced age, and unfortunately, they’re right: you are halfway to the grave, actuarially speaking. 🤔

But don’t worry, your best decades are still ahead of you if you pay attention to health in your 40s, and that starts with a quick trip to the doctor every few years.

The thing is…men don’t like going to the doctor, so too often we just don’t go. Apparently 72% of us would rather clean a toilet, probably because we don’t want to feel vulnerable nor admit that we’re not superheroes.

I get it: besides a few gray hairs and sliding into a “dad bod,” all systems seem to still be working. This makes it the opportune time to invest in some preventive maintenance and system checks. Prevention is easier than making repairs later.

Good news: This is going to be quick and easy for you, probably nearly painless too. If everything checks out, you’re off the hook for the next three years. There is not a good reason to procrastinate, and the following information will give you all the highlights of what you need to discuss and look out for.

This is the big one that many guys are secretly scared about. At 40 you are not likely to have a heart attack, but how you care for your cardiovascular system today determines your risks moving forward. The goal for your heart and circulatory system is to check some basics and optimize for a healthy future.

Consider prepping ahead of time for this visit by checking your blood pressure. Go ahead, stick your arm in the cuff at the pharmacy, take a deep relaxing breath, and push the button. Normal? High? It would be smart to check your blood pressure annually. If it’s high-or just barely high-what can you do about it? A healthy diet and exercise are always the first step, but if your doctor recommends medication be sure to discuss the pros and cons of treatment.

Think about your risk of Cardiovascular Disease. What is your age, your blood pressure, your risk factors? I like this risk calculator, despite it being British. American Heart’s calculator is good as well but requires you to know your blood pressure and cholesterol (more on that in a second).

Spend some time discussing cardiac heath with your doctor. You’ll be reviewing risk factors including diet, exercise, and family history. How can your individual risk factors be mitigated?

What is your cholesterol? You are about to find out because your doctor will be ordering this lab test. You won’t need a full lipid panel-just checking a total cholesterol and HDL will be fine-and you won’t need to be fasting for this blood test.

What is your BMI, and how motivated are you to improve it? Do you have elevated blood sugar? A fasting blood glucose (or a non-fasting) hemoglobin A1C will tell you and your provider everything you need to know. (This is your second and laboratory test, and can be run off the same single blood draw that checks your cholesterol) Do not accept a diagnosis of “borderline” diabetes, as there really is no such thing; mild elevation of fasting glucose or A1C should be treated aggressively with dietary and activity modifications.

Cancer prevention at this age is straightforward: Don’t smoke! Be fit and active. Eat a healthy diet low in fat and high in fiber. Consume alcohol in responsible amounts. Stay out of the sun and use SPF sunscreen.

Cancer screening is likely pretty easy at this age as well, although it will depend a bit on your risk factors.

Colon/GI Cancer: If you have a parent or sibling who has had colon or GI cancer, you need screening. Otherwise, you’re off the hook until age 50.

Lung Cancer: Even if you smoke, screening is not recommended until age 55.

Prostate: unless you have are black or have a family history of prostate cancer in someone under the age of 65, you can wait on this until age 50.

Skin: Most men can wait until age 50 for melanoma screening, although if you have fair skin and a history of sunburns or chronic exposures, it may be worthwhile to consider seeing a dermatologist now.

Get your flu shot already! This is flu season right now, and from what I’ve seen in the ER, burly men with beards turn into whimpering babies when they have legit influenza, so invest in prevention. If you haven’t had a tetanus shot (Tdap) in the last 10 years, now is a good time as well. Getting one at ages 40, 50, 60, and 70 makes it’s easy to remember where you are on the 10-year interval.

As a 40-something male, you are considered sexually boring, epidemiologically speaking, and thus not worth testing.

And yet we are all individuals, and maybe you are not boring. For example, maybe you’re single and dating or having sex with male partners or are swinging with that couple you met in the Best Western hot tub. If that’s the case, then testing for Chlamydia, Gonorrhea, HIV, and syphilis is advisable as these infections can lurk quietly without causing symptoms.

Start exercising. No really, you should start now! Take up jogging, cycling, get yourself a Peloton, do something or anything, and your heart will thank you. Also, lose some weight. Bonus points (and better bone density) if you gain some muscle mass by doing at least a little lifting. Finally, it is time to quit smoking. You can still drink, just don’t binge and don’t do it every night.

Check your blood pressure and watch your BMI. Get your cholesterol and blood sugar checked, and deal with any abnormal results. Talk with your doctor about lifestyle and genetic risks for the big stuff: cardiac and cancer. Have fun and enjoy your 40s, it’s going to be a great decade!

Doctor, Reader, Thinker

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