Dr. Liji George shares tips for staying healthy in your 40s and notes the importance of regular check-ups and screenings.
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Staying Healthy in Your 40s
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Learn more about Liji George, MD
Liji George, MD
Dr. Liji George is board certified in family medicine and places an emphasis on preventive medicine, along with building relationships with her patients. She works toward creating a personalized treatment plan, while ensuring quality and open communication. An accomplished author, Dr. George has contributed articles to peer-reviewed publications such as the Florida Family Physician. She is a member of the Florida Academy of Family Physicians, the American Medical Association, the American Academy of Family Physicians and the Neurological Injury Compensation Association of Florida.Learn more about Liji George, MD
Transcription:
Staying Healthy in Your 40s
Melanie Cole, MS (Host): When you're in your 30s, it doesn’t seem so important to really concentrate on your health. But as you approach your 40s, having an annual physical and wellness exam is so important to your overall health and one of the best ways to be proactive and be your own best health advocate. My guest today is Dr. Liji George. She’s a family medicine physician with BayCare Health System. Dr. George, tell us a little bit about entering our 40s. As I am quite a bit past that, I have an idea of what you're going to say. But as people enter their 40s, what do they need to keep in mind as far as their health that they didn’t need to keep in mind in their 20s and 30s.
Liji George MD (Guest): So usually in your 20s and 30s, most of us are pretty healthy. We may not be making our annual health exams. Everyone is busy behind making their careers and things like that. Once you reach 40, you have to start taking care of your health. So one of the first things that we recommend is an annual health exam with your primary care provider in the office. Now, when it is annual health exam, I should say this. Most of the insurances do approve it, but some of them do have some deductible copays and coinsurance based on your plans. Most of them do approve annual health exam. So when you come in for your annual health visit, we do check certain basic stuff, which is we screen the patients for high blood pressure. So we will check your blood pressure in the office and see what it is running. Usually we would like the blood pressure to be 120 over 80. Anything above that, we have to closely monitor. Patients with high risk—like family members having cardiovascular disease. So we need to closely monitor them. So you kind of get a heads up when you come to the doctor’s office and do this annual health check.
We do order some basic blood work as well. Just to see what your cholesterol is. Again, it’s something which is recommended for people who are overweight or obese, and also people who have a strong family history of any coronary heart disease, like cardiovascular disease. We screen for diabetes or elevated blood sugar. It’s recommended for people from 40 to 70 years of age, and especially for people who are overweight and obese. So if we see that, then we can counsel them in regards to healthy diet, physical activity, and things like that. So that’s one of the first things we recommend. To make an appointment with your primary care provider and then get some basic tests done, like I mentioned.
Host: Another thing that happens as we enter our 40s, especially for women, maybe we've already had children, but that’s sort of the time we start thinking about our increased risk of breast cancer. What are the guidelines, the latest guidelines, on starting mammograms or getting that baseline mammogram?
Dr. George: So the recommendation as per USPSTF for breast cancer screening starts from 50 years of age. It starts every two years screening mammogram for women aged 50 to 74 years. Screening mammogram in women from 40 to 49 years of age is still not recommended, but it is recommended for people who are at higher risks. So when I say people who are at high risk are patients who have underlying any genetic mutations. Like they have BRCA 1 or 2 gene mutation, or they have some familial breast cancer syndrome. They had some kind of chest radiation at their young age. So these patients are at very high risk. So these patients we do recommend to get a mammogram done in between 40 to 49 years of age. To answer your question, the mammogram is for patients from 50 to 74. That’s every two years.
Host: What about—You mentioned family risk of various diseases. Along those lines, we also think about vaccinations. So are there certain vaccinations we should be receiving as adults and especially in our 40s that you want us to know about?
Dr. George: Yes. So when it comes to vaccinations, basically most of the adults are vaccinated. At least, we think they are vaccinated in their childhood and their vaccination schedules are up to date. So there are two vaccines basically in your 40s if you have not received, or if you have received and completed the course but you need a booster vaccination. So tetanus is one of those vaccinations which you should receive at the age of 40. If you have finished your Tdap and DTaP series, then you are looking just for a tetanus booster vaccination. If you have not received your Tdap vaccination booster, then one of the tetanus vaccinations your primary care provider can give you as a Tdap vaccination. So that’s one of them.
The next one is your flu vaccination. So you need to have your annual flu vaccination. The flu season runs from September to March and most of the primary care providers office have their up to date flu vaccinations from August. So it’s highly recommended everyone to get their flu vaccination for that particular year as well. So those are the two major vaccinations that we give for men or women at the age of 40.
Host: Again, as women get older, we start to think about things like bone health. Is that the time we need to really concern ourselves with not only our weight management and exercise and vitamin D, but also screening for osteoporosis. Does that happen that early or not really?
Dr. George: So vitamin D supplementation, especially that is recommended, but there is no screening yet. At 40s, we will not be screening for osteoporosis or osteopenia with a DEXA scan. Again, there are certain people who are at high risk. Now, those are the only patients we will be screening with a DEXA or a bone density scan at that age. 1200 international units of vitamin D is a good supplementation to have. It helps. So anyone who would like to take vitamin D, that’s the dose that we recommend. With calcium, especially for women, that’s helpful as well. We will not be doing DEXA screening at that age, at that 40 to 50 age frame. We will not be doing DEXA scan.
Host: I think, Dr. George, one of the important things for people in their 40s—And as I said, I'm quite a bit past that, but it’s a busy time. Maybe you have young kids or even teenagers. You're working a job. There's so much going on. What about stress management? Sleep and depression screening? These seem to be really important factors in remaining healthy, especially in your 40s.
Dr. George: Yes, it does. So as you mentioned, every one of us are busy doing, like a lot of things is going on. Self-relaxation techniques to cope up with your daily activities, your work schedule. So that’s yoga, exercise. It does help. It helps with your weight management. We recommend 30 minutes of brisk walking or something like that five days a week to keep it going. It also helps to reduce your stress level. Of course, as I mentioned, vitamin supplementations like vitamin D, vitamin B12. Those type of things.
When you come to our offices, when you visit your primary care provider, we always do depression screening. So there are different type of depression screening tools that are available. Most of the offices do something that we call PHQ 2, which is patient health questionnaire which consists of two questions. This is a very simple tool and it’s just quick two questions. That helps us screen the patients whether they are having any initial signs or symptoms of depression. As I said, it’s just two questions. If the patient answers to both the questions as positive, or it comes back as plus one, either of the questions is positive, then we screen them with much more detailed questionnaire which is called PHQ 9. So that consists of nine questions.
That gives us a pretty good in-depth idea about whether the patient is depressed. Like how their sleep is. We recommend a good eight hours of sleep a night. So that questionnaire gives you an idea about whether the patient is suffering for depression, at what level—mild, moderate, severe. Counselling follows. Whether medication is needed at this point. So that is just the tool that we use for screening. From there, it helps us to navigate how we need to treat this patient at this point.
Host: Wow, what great information Dr. George. As we wrap up, give the listeners your best advice about being our own best health advocate in our 40s and beyond, and what you want us to know about alcohol intake and diet and exercise and our annual well exams. Kind of summarize it all for us on the importance of these things, what you want us to know.
Dr. George: Yes. So I want everyone to be aware about their health. Of course, you are in your 40s now. It’s not like being in 20s or 30s. We need to seriously take care of our health at this point onwards if you have not done it in the past. So the first thing to do is go ahead and call your primary care physician, make an appointment. When you go in there, your blood pressure, your cholesterol, your diabetes, depression, alcohol usage. Are you using more alcohol which you did not realize? So these certain basic things are going to be checked right then and there as you walk into a primary care physician’s office.
Once you are there then we can talk about the family risk. What's your family history? Whether we need to start early mammograms. Another thing is pap smear. Definitely we need to do pap smear as well for women. So these things which, like you can sit down and have a conversation with your primary care physician about. Tobacco screening, like if you're a smoker to discuss about how to quit. What are the options available? How can we quit? How is it going to effect your health going forward?
So then weight, definitely. Like am I overweight? Am I in obese category according to my BMI? What do I need to do for that? Exercise. Vitamin supplementation that I need to take every day, which I did not used to take before. So these things are the major ones that we discuss for any patient who comes in, men or women, at the age of 40s. That’s what we discuss. So that will be a great starting point. From there, what is needed is taken care of.
Host: Such great information Dr. George. Thank you so much for joining us and sharing your expertise and letting people in their 40s know really what's most important to concentrate on as they get into their 50s and beyond. Thank you, again. That wraps up this episode of BayCare HealthChat. Head on over to our website at baycare.org for more information and to get connected with one of our providers. If you found this podcast as informative as I did, please share on your social media and be sure to check out all the other interesting podcasts in our library. I'm Melanie Cole.
Staying Healthy in Your 40s
Melanie Cole, MS (Host): When you're in your 30s, it doesn’t seem so important to really concentrate on your health. But as you approach your 40s, having an annual physical and wellness exam is so important to your overall health and one of the best ways to be proactive and be your own best health advocate. My guest today is Dr. Liji George. She’s a family medicine physician with BayCare Health System. Dr. George, tell us a little bit about entering our 40s. As I am quite a bit past that, I have an idea of what you're going to say. But as people enter their 40s, what do they need to keep in mind as far as their health that they didn’t need to keep in mind in their 20s and 30s.
Liji George MD (Guest): So usually in your 20s and 30s, most of us are pretty healthy. We may not be making our annual health exams. Everyone is busy behind making their careers and things like that. Once you reach 40, you have to start taking care of your health. So one of the first things that we recommend is an annual health exam with your primary care provider in the office. Now, when it is annual health exam, I should say this. Most of the insurances do approve it, but some of them do have some deductible copays and coinsurance based on your plans. Most of them do approve annual health exam. So when you come in for your annual health visit, we do check certain basic stuff, which is we screen the patients for high blood pressure. So we will check your blood pressure in the office and see what it is running. Usually we would like the blood pressure to be 120 over 80. Anything above that, we have to closely monitor. Patients with high risk—like family members having cardiovascular disease. So we need to closely monitor them. So you kind of get a heads up when you come to the doctor’s office and do this annual health check.
We do order some basic blood work as well. Just to see what your cholesterol is. Again, it’s something which is recommended for people who are overweight or obese, and also people who have a strong family history of any coronary heart disease, like cardiovascular disease. We screen for diabetes or elevated blood sugar. It’s recommended for people from 40 to 70 years of age, and especially for people who are overweight and obese. So if we see that, then we can counsel them in regards to healthy diet, physical activity, and things like that. So that’s one of the first things we recommend. To make an appointment with your primary care provider and then get some basic tests done, like I mentioned.
Host: Another thing that happens as we enter our 40s, especially for women, maybe we've already had children, but that’s sort of the time we start thinking about our increased risk of breast cancer. What are the guidelines, the latest guidelines, on starting mammograms or getting that baseline mammogram?
Dr. George: So the recommendation as per USPSTF for breast cancer screening starts from 50 years of age. It starts every two years screening mammogram for women aged 50 to 74 years. Screening mammogram in women from 40 to 49 years of age is still not recommended, but it is recommended for people who are at higher risks. So when I say people who are at high risk are patients who have underlying any genetic mutations. Like they have BRCA 1 or 2 gene mutation, or they have some familial breast cancer syndrome. They had some kind of chest radiation at their young age. So these patients are at very high risk. So these patients we do recommend to get a mammogram done in between 40 to 49 years of age. To answer your question, the mammogram is for patients from 50 to 74. That’s every two years.
Host: What about—You mentioned family risk of various diseases. Along those lines, we also think about vaccinations. So are there certain vaccinations we should be receiving as adults and especially in our 40s that you want us to know about?
Dr. George: Yes. So when it comes to vaccinations, basically most of the adults are vaccinated. At least, we think they are vaccinated in their childhood and their vaccination schedules are up to date. So there are two vaccines basically in your 40s if you have not received, or if you have received and completed the course but you need a booster vaccination. So tetanus is one of those vaccinations which you should receive at the age of 40. If you have finished your Tdap and DTaP series, then you are looking just for a tetanus booster vaccination. If you have not received your Tdap vaccination booster, then one of the tetanus vaccinations your primary care provider can give you as a Tdap vaccination. So that’s one of them.
The next one is your flu vaccination. So you need to have your annual flu vaccination. The flu season runs from September to March and most of the primary care providers office have their up to date flu vaccinations from August. So it’s highly recommended everyone to get their flu vaccination for that particular year as well. So those are the two major vaccinations that we give for men or women at the age of 40.
Host: Again, as women get older, we start to think about things like bone health. Is that the time we need to really concern ourselves with not only our weight management and exercise and vitamin D, but also screening for osteoporosis. Does that happen that early or not really?
Dr. George: So vitamin D supplementation, especially that is recommended, but there is no screening yet. At 40s, we will not be screening for osteoporosis or osteopenia with a DEXA scan. Again, there are certain people who are at high risk. Now, those are the only patients we will be screening with a DEXA or a bone density scan at that age. 1200 international units of vitamin D is a good supplementation to have. It helps. So anyone who would like to take vitamin D, that’s the dose that we recommend. With calcium, especially for women, that’s helpful as well. We will not be doing DEXA screening at that age, at that 40 to 50 age frame. We will not be doing DEXA scan.
Host: I think, Dr. George, one of the important things for people in their 40s—And as I said, I'm quite a bit past that, but it’s a busy time. Maybe you have young kids or even teenagers. You're working a job. There's so much going on. What about stress management? Sleep and depression screening? These seem to be really important factors in remaining healthy, especially in your 40s.
Dr. George: Yes, it does. So as you mentioned, every one of us are busy doing, like a lot of things is going on. Self-relaxation techniques to cope up with your daily activities, your work schedule. So that’s yoga, exercise. It does help. It helps with your weight management. We recommend 30 minutes of brisk walking or something like that five days a week to keep it going. It also helps to reduce your stress level. Of course, as I mentioned, vitamin supplementations like vitamin D, vitamin B12. Those type of things.
When you come to our offices, when you visit your primary care provider, we always do depression screening. So there are different type of depression screening tools that are available. Most of the offices do something that we call PHQ 2, which is patient health questionnaire which consists of two questions. This is a very simple tool and it’s just quick two questions. That helps us screen the patients whether they are having any initial signs or symptoms of depression. As I said, it’s just two questions. If the patient answers to both the questions as positive, or it comes back as plus one, either of the questions is positive, then we screen them with much more detailed questionnaire which is called PHQ 9. So that consists of nine questions.
That gives us a pretty good in-depth idea about whether the patient is depressed. Like how their sleep is. We recommend a good eight hours of sleep a night. So that questionnaire gives you an idea about whether the patient is suffering for depression, at what level—mild, moderate, severe. Counselling follows. Whether medication is needed at this point. So that is just the tool that we use for screening. From there, it helps us to navigate how we need to treat this patient at this point.
Host: Wow, what great information Dr. George. As we wrap up, give the listeners your best advice about being our own best health advocate in our 40s and beyond, and what you want us to know about alcohol intake and diet and exercise and our annual well exams. Kind of summarize it all for us on the importance of these things, what you want us to know.
Dr. George: Yes. So I want everyone to be aware about their health. Of course, you are in your 40s now. It’s not like being in 20s or 30s. We need to seriously take care of our health at this point onwards if you have not done it in the past. So the first thing to do is go ahead and call your primary care physician, make an appointment. When you go in there, your blood pressure, your cholesterol, your diabetes, depression, alcohol usage. Are you using more alcohol which you did not realize? So these certain basic things are going to be checked right then and there as you walk into a primary care physician’s office.
Once you are there then we can talk about the family risk. What's your family history? Whether we need to start early mammograms. Another thing is pap smear. Definitely we need to do pap smear as well for women. So these things which, like you can sit down and have a conversation with your primary care physician about. Tobacco screening, like if you're a smoker to discuss about how to quit. What are the options available? How can we quit? How is it going to effect your health going forward?
So then weight, definitely. Like am I overweight? Am I in obese category according to my BMI? What do I need to do for that? Exercise. Vitamin supplementation that I need to take every day, which I did not used to take before. So these things are the major ones that we discuss for any patient who comes in, men or women, at the age of 40s. That’s what we discuss. So that will be a great starting point. From there, what is needed is taken care of.
Host: Such great information Dr. George. Thank you so much for joining us and sharing your expertise and letting people in their 40s know really what's most important to concentrate on as they get into their 50s and beyond. Thank you, again. That wraps up this episode of BayCare HealthChat. Head on over to our website at baycare.org for more information and to get connected with one of our providers. If you found this podcast as informative as I did, please share on your social media and be sure to check out all the other interesting podcasts in our library. I'm Melanie Cole.