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Taylor Leddin-McMaster (Host): Welcome back to the Well Within Reach podcast, brought to you by Riverside Healthcare. I'm your host, Taylor Leddin-McMaster. And joining me today is Dr. Maryann Kelly, a primary care provider at the Riverside Frankfort Campus. She's here to talk about why regular lab work matters for your long-term health. Thank you for being here.

Dr. Maryann Kelly: Yes. Thank you for having me.

Host: Of course. Before we get into the topic of conversation, can you tell us a little bit about yourself and your background?

Dr. Maryann Kelly: Yeah. So, I grew up in the Frankfort area. I've lived here almost my whole life. I love this area and I'm so happy to be giving back to the community here. I've been practicing internal medicine for about six years now, six years outside of residency.

Host: Awesome. That's great. I'm also from Frankfort, so love it here. What are some of the most common routine lab tests that primary care providers recommend for adults, and what can they tell us about our overall health?

Dr. Maryann Kelly: Yeah. So, the most common ones are two, a CBC and a CMP. A CBC looks at your cell line counts. So, it's looking at your red cell line counts, which can tell us if you're anemic. It's looking at your platelet counts. It's looking at your white blood cell counts. And so, we can see what those lines are doing. And then, a CMP or a BMP, either can look at your liver, your kidneys, and your electrolytes. That's the information that's telling us. So, a lot of information comes from just those two labs.

Host: Yeah, it sounds like it. Would you say there are certain lifestyle habits, medications, or family history factors that make regular lab monitoring even more important?

Dr. Maryann Kelly: Oh, 100%. Certain medications you have to check for your liver and your kidneys, make sure the function is okay. Family history, if you have family history of diabetes or thyroid issues, I'm more inclined to go and take a look at those labs. And lifestyle, you know, struggling with weight, I got to check your cholesterol. I got to check for diabetes. I have to make sure those things are okay.

Host: Why is it important to establish a baseline through routine lab work even if you're a healthy person?

Dr. Maryann Kelly: So, it's important to have a baseline because let's say you come in one time and all of a sudden your kidneys are not functioning well. Well, if you come in and that's your first lab, I don't know what your baseline is. I have no idea where you started. So if you're healthy, we should just be monitoring it, because trends are more important than just a one singular lab value.

Host: Yeah, that makes total sense. So, you have something to compare it to. Well, great. Before we continue our conversation, we're going to have a quick break to talk about primary care at Riverside.

At Riverside, our primary care providers are right here in your community offering personalized care for you and your family, close to home and connected to the specialists and services you may need. Having a primary care provider means having someone who knows you, listens to you, and helps you stay well through every stage of life, from annual checkups and preventative screenings to managing everyday concerns when they pop up, because remarkable care should never be out of reach. Remarkable care right where you live.

To find a primary care provider who's right for you and your family, visit myrhc.net/acceptingnew.

So, we are back to talking about routine lab work and why that's important for long-term health. How can regular lab work help uncover health risks or conditions early even before symptoms appear, and what might be some examples of that?

Dr. Maryann Kelly: So, I got great examples of that. We can catch prediabetes—it used to be called prediabetes. It's now called impaired fasting glucose. But we can catch that when they don't have symptoms early with lab work. And so, that's an opportunity for me to tell a patient, "Hey, diet and exercise actually reverses this, and so you could stop yourself from going to full-blown diabetes and you could go back into the normal A1c rangs." So, that's a big one.

Another one is like we talked about, kidney disease. You don't have any symptoms from early kidney disease. You'd have no idea. So, you come in, your kidneys aren't working a little bit. Sometimes it can be from dehydration, you just worked out, there's reasons for it, infection. But I need to see a trend, so I have to repeat it and make sure, "Oh, okay, we do have kidney disease." And so, we need to be mindful of what medications we're taking, we're hydrating ourselves properly. And then, we're preventing it from going terrible in the future.

Host: Yeah. Those are important things to pay attention to. So, we had talked about trends and the importance of having kind of a baseline of lab work done. Can you expand a little bit on how trends in lab results over time help a provider to get a more complete picture of a patient's long-term health?

Dr. Maryann Kelly: Yeah. For long-term health, the trends can tell us a lot of things. For example, I'll stick with the kidney example. We have something called GFR. It stands for glomerular filtration rate. And basically, your kidneys are like the filtration to your entire bloodstream, like you would filter your furnace in your house. It's changing that filter out. So if it gets damaged, you're not filtrating those things out of your blood correctly. And so, GFRs can decrease as it's damaging. So, we would trend that. And over long-term health, that would tell me, "Okay, we need to see a kidney specialist," "Oh, okay, we might need dialysis."

So, it's monitoring these trends long term that would tell me the overall patient's health in multiple ways. Anemia is another one. Diabetes is another one. There's so many. We're just trending it and saying, "Okay, we're actually stable, and we know that that's a patient baseline." And it's based off the patient individually. So, like, one patient can come in, and they have mild kidney disease. Another patient doesn't, but they're still functioning in their everyday life okay, because it's just patient to patient.

Host: Yeah. That's got to be really interesting to monitor all of that and see how it, like you said, changes between each person. That's fascinating.

Dr. Maryann Kelly: And even thyroid. Thyroid is a big one. Some patients, they'll have, you know, slight change in their thyroid and they have all of these symptoms. And then, I have patients who have giant changes in their thyroid and they have no symptoms. So, it's really different between patients, and it's just treating everybody as an individual rather than, like, just saying, "Oh, you're within the range, you're fine," kind of thing.

Host: Yeah. So, I love that you said that. would you say that treating each patient as an individual is your mantra for providing care for people?

Dr. Maryann Kelly: A hundred percent. Some patients, like I just said, they have no symptoms and their labs are out of whack. I still have to treat it, Because their labs are really out of whack. But then, I have patients who, it's so sad, they're going to providers and they're complaining about these things that are really bothering them. And you go and actually dissect their labs and you're like, "Actually, you're low normal."

I'll give you a great example. For example, TSH, which is the thyroid lab, okay? It is a hormone in your body, and basically the range for normal is 0.5 all the way way up to 4, okay?

Host: Wow!

Dr. Maryann Kelly: That's a wide range. So if you're always hanging out around 4 or 3.5 or something, and then all of a sudden you drop down to a 0.8, you're still within normal range. And so, a doctor might see and be like, "Well, you're in normal range. You're fine."

But really, what you should do is look back at the trend and say, "No, actually, you've been coming down consistently," or "You dropped dramatically. No wonder you're feeling all these symptoms," you know? It's putting the picture together rather than just being like, "Oh, you're in within normal range. You're okay." You know?

Host: It's all in your head." It's not.

Dr. Maryann Kelly: Yeah. You know? Like, it's so unfair to them. Yeah. So yeah, it's taking that time to actually individually listen to what's going on, and then using your medical knowledge to go and basically be a detective.

Host: Oh, I like that perspective on it. Thank you for sharing that. How often should adults have routine lab work done? And does that change based on age or medical history?

Dr. Maryann Kelly: It definitely changes on age and medical history. I would say young adults, like in their 18 to about early or late 20s, every year, maybe a baseline. Some studies have showed every other year is okay because they're young. As long as they don't have any medical history, that's fine. They have a thyroid problem or diabetes, that's different. They have to get checked more frequently.

As you get older, I would say every year, we should be seeing a trend on all of the labs. But I would say medical health is probably the biggest factor there, right? So if somebody has thyroid, diabetes, kidney disease, anemia, what have it, they need to be monitored more frequently based off of if they're stable or not, or if we're trying to get them to a stable base.

Host: Okay. What is your advice for someone who hasn't seen a primary care provider or had a routine lab work done in a few years?

Dr. Maryann Kelly: Oh my gosh, come in, come see me. Get your lab work done. It's just sad sometimes when you see people who, like, did not take care of their health, and then they come in and there's, like, this laundry list. And I love getting them back to a normal state. But sometimes I want to say, "We could have prevented a lot of these things if you just came," you know? I make it really painless For them to come and see me and just kind of walk them through, like, "Hey, we're just going to get a baseline of things. We're going to see where you're at."

But then, sometimes they're, like, complaining of these symptoms. I'm like, "Ugh, you might have diabetes," or I could just tell right away. And then, we get it back... And I just actually had a patient come in and they did. They had an A1c over 14, which is very high. Normal is under 5.7. So, it's double of what it should be. And bringing that patient down wonderfully and they're like, "I feel better." And I'm like, "I wish you would've just came earlier and we could have prevented all this from happening." So yeah, if you do not have a primary care, come to Frankfort and come see Dr. Kelly or Dr. George.

Host: Fantastic. Before we end today, is there anything else you wanted to add to the conversation?

Dr. Maryann Kelly: I would actually add that sometimes patients get their labs back and they see like one red lab and they kind of have spiraling panic attack. I like to always tell them, like one lab does not give us a picture. It's just a puzzle to a bigger picture. It doesn't tell us much.

And sometimes those labs are actually data points. They don't tell us anything at all unless something else is abnormal. So. I would caution people to go onto ChatGPT or Google that lab and find out that they have cancer or something. You know, because ChatGPT and Google are going to give you the worst-case scenario. And I would just know that if it is something serious, your doctor's going to call you about it.

Host: That's great advice, because definitely been in that position before where I'm like, "Oh no, I have to Google everything that this means," then you get more freaked out. So, yeah, take it from someone who's done it. Don't do it.

Thank you so much, Dr. Kelly, for being here today. And thank you listeners for tuning into the Well Within Reach podcast. Be sure to like and subscribe to Well Within Reach on Apple, Spotify, or wherever you get your podcasts. To learn more about the services at Riverside Healthcare or to book an appointment with a primary care provider such as Dr. Kelly, go to riversidehealthcare.org.