Selected Podcast
The Importance of Preventative Medicine
Preventative medicine is so important to our healthcare but what exactly does preventative care mean? Dr. Tamar Toronjadze discusses the concept of preventative medicine and how we can incorporate it into our lives.
Featured Speaker:
Tamar Toronjadze, MD
Dr. Tamar Toronjadze is a graduate of Tbilisi State Medical University. She completed her Internal Medicine residency and Geriatric fellowship in Flushing Hospital Medical Center, Flushing NY. Currently, she is an associate program director of the Internal Medicine training program at the same institution. Along with supervising young doctors in training, she had been providing primary care to adult patients for the past 15 years. Transcription:
The Importance of Preventative Medicine
Caitlin Whyte: Preventative medicine is so, so important to our health care. But what exactly does preventative care mean? Joining us to talk more about this is Dr. Tamar Toronjadze, the Associate Program Director of the Internal Medicine Training Program at Flushing Hospital.
This is Flushing Hospital Med Talk. I'm your host, Caitlin Whyte. Well, doctor, let's start with the question from the top of our intro. Explain to us the concept of preventative medicine and why it is so important for people to adopt this practice.
Dr. Tamar Toronjadze: You have probably heard the quote, "The greatest victory is that which requires no battle." This quote is credited to an ancient military strategist, Sun Tzu. This wisdom could be applied to battling illnesses and maintaining health as well. Most of my colleagues, internal medicine physicians come to the field because we strongly believe that preventing a disease is better than curing it. Insurance providers know this well. Every insurance provider covers preventive visits and screening tests. These visits will entail interview with your primary care doctor who will obtain your history, will check your weight, vital signs, perform physical exam and devise a plan depending on your history, risk factors for certain conditions and physical exam findings. The plan may include various tests, such as blood tests, mammogram, pap smear, colonoscopy, chest CAT scan for some long-term smokers, immunizations. Your doctor will screen for depression. There will be counseling and advice for leading a healthy lifestyle.
Caitlin Whyte: So is this a philosophy that everyone should adopt or just people with certain underlying conditions? Who is this good for?
Dr. Tamar Toronjadze: When we say preventive care, we mean stopping a disease from occurring in the first place. However, it can also include prevention of flares and recurrences if the condition is already present. When I refer a healthy 45-year-old patient to a gastroenterologist for a screening colonoscopy, sometimes I am questioned, "But why? I don't have any complaints." Well, screening colonoscopies detect asymptomatic precancerous polyps in the rectum and colon. Once the polyps become cancerous or symptomatic, the treatments may involve extensive surgery, chemotherapy, radiation. You can avoid all of this with simple polyp removal during colonoscopy. Colorectal cancers are second most common cause of cancer-related deaths in men and women combined and screening colonoscopies reduce this numbers. Routine mammograms will find breast cancers in early stages before they become detectable on physical exam. The treatment in early stage is much less complex compared to advanced stages of the disease. A doctor may also find that your blood pressure is elevated, even if you experienced no symptoms. However, elevated blood pressure is the leading cause of a stroke. Every year, about 800,000 people in the United States have a stroke. This means every 40 seconds, someone in the United States has a stroke. In every three and a half minutes, someone dies of stroke. And the disturbing fact is 80% of all strokes are preventable.
Now, immunizations prevent most infections and reduce infection-related deaths in healthy individuals, as well as in patients with chronic conditions. So yes, all of us should adopt this practice.
Caitlin Whyte: So it sounds like starting early is definitely key. Then, what are some of your tips for someone to practice preventative care?
Dr. Tamar Toronjadze: Make sure you visit your primary care physician once a year for wellness check and follow up as advised by your doctor. During this wellness checks, if some tests that ordered, certain conditions that are detected and monitoring is needed, a follow-up will be necessary. For monitoring a chronic condition, you will likely need three to six months follow-up depending on severity of your condition.
Now, some will be wondering, "What sort of screenings I might need for my demographics?" Starting from age 21, Pap smear, the screening for cervical cancer and every three to five years thereafter, if normal. At age 40, a mammogram once a year for most females. At age 45, colonoscopy once every 10 years for a person with average risk for colorectal cancer. By the way, screening age was recently changed from 50 to 45. Annual CAT scans for 50 to 80-year-old patients who have 20-pack year smoking history and still smoke or quit less than 15 years ago. To clarify, a person who smokes one pack a day for 20 years everyday. Tetanus and diptheria vaccination every 10 years. At age of 50, two shingles vaccine six months apart. At age 65, two pneumococcal pneumonia vaccines six months apart. Patients with some chronic conditions will need pneumococcal pneumonia immunization even earlier. Annual flu vaccine for everyone. One time screening for hepatitis C for every adult. Annual HIV screening for everyone. Screening for abdominal aortic aneurysm in the elderly if they ever smoked. Screening for osteoporosis after age of 60, et cetera. And the list goes on and on.
Before your first visit, make sure you have done your homework and are prepared, so you can efficiently use your time spent with your doctor. Make sure you have your medical-surgical histories written down as well as your medications names, durations, doses, frequencies, last dose taken. Don't forget about over-the-counter medicines. Remember allergies to food and medicines that you may have had in the past as well as types of reactions. An accurate family history may be instrumental in your care and the decisions that your doctor was making to keep you healthy. These are some of the tips.
Caitlin Whyte: Wonderful, wonderful. And on that note, you touched on some of them. But what are some other lifestyle choices that a person can make to practice this preventative care?
Dr. Tamar Toronjadze: Again, visit your doctor on a regular basis. Have screening tests. Get immunized. Eat healthy diet rich with fiber; low in simple carbs, cholesterol and sodium. Stay active and try yoga and meditation to control stress, improve endurance, balance, flexibility, and keep normal body mass index.
If you have chronic conditions, however, more will be needed. For example, say, you have high blood pressure, diabetes, elevated cholesterol, and you have recently had a stroke. Your doctor's agenda will be to prevent another stroke and improve your function. This will be achieved by controlling your elevated blood pressure, cholesterol, blood sugar with medications, and by detecting major artery narrowing and ordering interventions. Engaging doing physical therapy. Atrial fibrillation or irregular heartbeat is another common cause of stroke. By detection and treatment, strong recurrence can be significantly reduced.
Good news is by achieving all this, you will be decreasing risk, not just for a stroke. But also decreasing risk of heart attack and heart failure, kidney failure, and need for hemodialysis, blindness, amputations, and risk for certain types of cancers as well.
Caitlin Whyte: Well, wrapping up here, doctor, just how can a preventative care model improve your life? Or conversely, what are some potential dangers of not staying on top of your health?
Dr. Tamar Toronjadze: Right. Healthy lifestyle, as described above, will improve not just your longevity, but quality of life as well. This applies to healthy individuals and patients with chronic conditions. Unfortunately, preventive care was greatly compromised during the COVID-19 pandemic and final consequences are yet to be measured. As per Centers of Disease Control report, there has been sharp declines in breast and cervical cancer screening rates. The decline was as deep as by 80% and 84% respectively in 2020, compared to prior years. The rates have rebounded after the drop, but still low in certain groups.
A lot more work needs to be done. Always remember, an ounce of prevention is worth a pound of cure. It is better to spend one day a year with your doctor than allow a disease to sidetrack the rest of your life.
Caitlin Whyte: Absolutely. I absolutely agree. Well, doctor, thank you so much for being with us today. We appreciate your time.
Dr. Tamar Toronjadze: It is my pleasure. Thank you.
Caitlin Whyte: To make an appointment at Flushing Hospital Medical Center, please call 718-670-5486. This has been Flushing Hospital Med Talk. I'm your host, Caitlin Whyte. Be well.
The Importance of Preventative Medicine
Caitlin Whyte: Preventative medicine is so, so important to our health care. But what exactly does preventative care mean? Joining us to talk more about this is Dr. Tamar Toronjadze, the Associate Program Director of the Internal Medicine Training Program at Flushing Hospital.
This is Flushing Hospital Med Talk. I'm your host, Caitlin Whyte. Well, doctor, let's start with the question from the top of our intro. Explain to us the concept of preventative medicine and why it is so important for people to adopt this practice.
Dr. Tamar Toronjadze: You have probably heard the quote, "The greatest victory is that which requires no battle." This quote is credited to an ancient military strategist, Sun Tzu. This wisdom could be applied to battling illnesses and maintaining health as well. Most of my colleagues, internal medicine physicians come to the field because we strongly believe that preventing a disease is better than curing it. Insurance providers know this well. Every insurance provider covers preventive visits and screening tests. These visits will entail interview with your primary care doctor who will obtain your history, will check your weight, vital signs, perform physical exam and devise a plan depending on your history, risk factors for certain conditions and physical exam findings. The plan may include various tests, such as blood tests, mammogram, pap smear, colonoscopy, chest CAT scan for some long-term smokers, immunizations. Your doctor will screen for depression. There will be counseling and advice for leading a healthy lifestyle.
Caitlin Whyte: So is this a philosophy that everyone should adopt or just people with certain underlying conditions? Who is this good for?
Dr. Tamar Toronjadze: When we say preventive care, we mean stopping a disease from occurring in the first place. However, it can also include prevention of flares and recurrences if the condition is already present. When I refer a healthy 45-year-old patient to a gastroenterologist for a screening colonoscopy, sometimes I am questioned, "But why? I don't have any complaints." Well, screening colonoscopies detect asymptomatic precancerous polyps in the rectum and colon. Once the polyps become cancerous or symptomatic, the treatments may involve extensive surgery, chemotherapy, radiation. You can avoid all of this with simple polyp removal during colonoscopy. Colorectal cancers are second most common cause of cancer-related deaths in men and women combined and screening colonoscopies reduce this numbers. Routine mammograms will find breast cancers in early stages before they become detectable on physical exam. The treatment in early stage is much less complex compared to advanced stages of the disease. A doctor may also find that your blood pressure is elevated, even if you experienced no symptoms. However, elevated blood pressure is the leading cause of a stroke. Every year, about 800,000 people in the United States have a stroke. This means every 40 seconds, someone in the United States has a stroke. In every three and a half minutes, someone dies of stroke. And the disturbing fact is 80% of all strokes are preventable.
Now, immunizations prevent most infections and reduce infection-related deaths in healthy individuals, as well as in patients with chronic conditions. So yes, all of us should adopt this practice.
Caitlin Whyte: So it sounds like starting early is definitely key. Then, what are some of your tips for someone to practice preventative care?
Dr. Tamar Toronjadze: Make sure you visit your primary care physician once a year for wellness check and follow up as advised by your doctor. During this wellness checks, if some tests that ordered, certain conditions that are detected and monitoring is needed, a follow-up will be necessary. For monitoring a chronic condition, you will likely need three to six months follow-up depending on severity of your condition.
Now, some will be wondering, "What sort of screenings I might need for my demographics?" Starting from age 21, Pap smear, the screening for cervical cancer and every three to five years thereafter, if normal. At age 40, a mammogram once a year for most females. At age 45, colonoscopy once every 10 years for a person with average risk for colorectal cancer. By the way, screening age was recently changed from 50 to 45. Annual CAT scans for 50 to 80-year-old patients who have 20-pack year smoking history and still smoke or quit less than 15 years ago. To clarify, a person who smokes one pack a day for 20 years everyday. Tetanus and diptheria vaccination every 10 years. At age of 50, two shingles vaccine six months apart. At age 65, two pneumococcal pneumonia vaccines six months apart. Patients with some chronic conditions will need pneumococcal pneumonia immunization even earlier. Annual flu vaccine for everyone. One time screening for hepatitis C for every adult. Annual HIV screening for everyone. Screening for abdominal aortic aneurysm in the elderly if they ever smoked. Screening for osteoporosis after age of 60, et cetera. And the list goes on and on.
Before your first visit, make sure you have done your homework and are prepared, so you can efficiently use your time spent with your doctor. Make sure you have your medical-surgical histories written down as well as your medications names, durations, doses, frequencies, last dose taken. Don't forget about over-the-counter medicines. Remember allergies to food and medicines that you may have had in the past as well as types of reactions. An accurate family history may be instrumental in your care and the decisions that your doctor was making to keep you healthy. These are some of the tips.
Caitlin Whyte: Wonderful, wonderful. And on that note, you touched on some of them. But what are some other lifestyle choices that a person can make to practice this preventative care?
Dr. Tamar Toronjadze: Again, visit your doctor on a regular basis. Have screening tests. Get immunized. Eat healthy diet rich with fiber; low in simple carbs, cholesterol and sodium. Stay active and try yoga and meditation to control stress, improve endurance, balance, flexibility, and keep normal body mass index.
If you have chronic conditions, however, more will be needed. For example, say, you have high blood pressure, diabetes, elevated cholesterol, and you have recently had a stroke. Your doctor's agenda will be to prevent another stroke and improve your function. This will be achieved by controlling your elevated blood pressure, cholesterol, blood sugar with medications, and by detecting major artery narrowing and ordering interventions. Engaging doing physical therapy. Atrial fibrillation or irregular heartbeat is another common cause of stroke. By detection and treatment, strong recurrence can be significantly reduced.
Good news is by achieving all this, you will be decreasing risk, not just for a stroke. But also decreasing risk of heart attack and heart failure, kidney failure, and need for hemodialysis, blindness, amputations, and risk for certain types of cancers as well.
Caitlin Whyte: Well, wrapping up here, doctor, just how can a preventative care model improve your life? Or conversely, what are some potential dangers of not staying on top of your health?
Dr. Tamar Toronjadze: Right. Healthy lifestyle, as described above, will improve not just your longevity, but quality of life as well. This applies to healthy individuals and patients with chronic conditions. Unfortunately, preventive care was greatly compromised during the COVID-19 pandemic and final consequences are yet to be measured. As per Centers of Disease Control report, there has been sharp declines in breast and cervical cancer screening rates. The decline was as deep as by 80% and 84% respectively in 2020, compared to prior years. The rates have rebounded after the drop, but still low in certain groups.
A lot more work needs to be done. Always remember, an ounce of prevention is worth a pound of cure. It is better to spend one day a year with your doctor than allow a disease to sidetrack the rest of your life.
Caitlin Whyte: Absolutely. I absolutely agree. Well, doctor, thank you so much for being with us today. We appreciate your time.
Dr. Tamar Toronjadze: It is my pleasure. Thank you.
Caitlin Whyte: To make an appointment at Flushing Hospital Medical Center, please call 718-670-5486. This has been Flushing Hospital Med Talk. I'm your host, Caitlin Whyte. Be well.