October 31, 2014

Executive Physicals & Wellness

Florida's Top Docs Talk Basics

Medical directors of executive health programs in Florida identify the essential health factors every executive shouldn't ignore.

Sleep Habits
Dr. Mark Moon, medical director at the Mayo Clinic’s Executive Health Program in Jacksonville, says lack of adequate, quality sleep contributes to early mortality and low sex drive. If you’re getting less than seven hours of sleep, awakening during the night or rising in the morning feeling fatigued, you may have a disorder such as sleep apnea. “We may have you see a sleep specialist,’’ Moon says. “When treated for sleep apnea, your energy improves and testosterone levels increase. At least once a week I see patients who have moderate or severe apnea who had no idea they had it.”

Belly Fat
Having a waist size of more than 40 inches can create serious medical problems. Moon at Mayo Clinic says carrying weight in your midsection can cause inflammation in your liver. Even more, he says, it can induce the pancreas to produce higher levels of insulin, promoting inflammation associated with other conditions, including malignancies. Dr. Dario Pancorbo, medical director for Baptist Outpatient Services’ Executive Health and Wellness program in Miami, says he spends time talking to patients about their eating and lifestyle habits. “I have found that many executives have a compulsive way of eating, and they tend to be sedentary.” Pancorbo brings in dietitians and fitness experts to counsel his patients. “We not only tell them what they need to do, we tell them how to do it.”

Test Questions

» Treadmill stress test: Dr. Mark Moon, medical director at the Mayo Clinic’s Executive Health Program in Jacksonville, recommends a treadmill stress test only after a consultation and discussion of family and personal history.

» Mammogram and pap smear: Most physicians suggest annual mammograms beginning at 40 unless there’s a family history of breast cancer. Dr. Dario Pancorbo, medical director for Baptist Outpatient Services’ Executive Health and Wellness program in Miami, says pap tests to screen for cervical cancer now are done annually along with HPV testing, which has recently been added.

 

Bone Density
Women over 50 are at risk of osteoporosis, a disease that causes bones to become more fragile and more likely to fracture. Dr. H. James Brownlee Jr., medical director of the Monsour Executive Wellness Center at USF Health in Tampa, says he orders a bone density test for most female executives 50 or older to measure calcium and minerals in a segment of bone. Women with a low body mass index, those who are thin, are at greater risk for osteoporosis, Brownlee says. Men in their 50s do not experience the rapid loss of bone mass that women do after menopause. Men’s ability to absorb calcium — and the risk for osteoporosis — doesn’t usually begin until at least age 65.

Vitamin D
Gould at Watson says low vitamin D levels are more prevalent these days, putting more men and women at risk for high-blood pressure, cancer and weak bones. Working indoors contributes to vitamin D-deficiency because the body makes vitamin D when exposed to sunlight. Some foods, such as milk, are fortified with vitamin D; however, when there is a deficiency, Gould typically recommends a supplement.

Ears and Eyes
Medical directors say they have begun to include hearing and vision tests as part of executive health exams. “It’s amazing how many people over
the age of 40 have some hearing loss,” says Brownlee. In some instances, significant hearing loss on one side can indicate pressure on the inner ear. Brownlee says he refers those patients to an ear, nose and throat specialist for evaluation. “When a leader sits around a conference table and people start to have cross conversations, he may start to lose word discrimination, and that’s an important part of hearing well.” Just as important is an eye exam, Brownlee says. He also asks ophthalmologists to check vision and look for glaucoma. “In the rat race, that’s something people tend to put off.”

Test Questions

» Hepatitis C: Baby Boomers account for 75% of hepatitis C cases in the United States, even though they make up only 27% of the population. Dr. H. James Brownlee Jr., medical director of the Monsour Executive Wellness Center at USF Health in Tampa, says he includes a one-time blood test to screen for hepatitis C as part of every routine executive health exam. The Centers for Disease Control says many Baby Boomers were infected with the virus decades ago without knowing it and could eventually develop liver cancer or other liver diseases.

Tags: Healthcare

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