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Staying tuned up after 50

Marcy Barack, Eons contributor

Hitting menopause sent me to a succession of doctors' offices with a cascading set of health concerns. It was tough to find the help I needed.

The guy who delivered my babies may have been up on the latest fertility research but not on what to do about vaginal dryness. My internist knew how to keep a sharp eye on my cholesterol but didn't have a clue about treating hot flashes. A pulmonary specialist took me off hormone replacement therapy after a blood clot scare and sent me for a bone scan. Jogging on a treadmill to build up my bones, I blew out my knee and wound up in the orthopedist's office.

For a healthy gal, I was beginning to feel like an invalid. Where's a woman to go with multiple health issues common to 50-somethings? Fortunately, I found what I was looking for nearby -- a practice devoted to women with doctors who set aside a generous amount of time to review my history, give me a thorough going over, listen to my concerns, and craft a comprehensive plan to keep me healthy.

Practices like these are springing up around the country, as the 50+ population continues to grow. You may be able to find a healthcare center focused on women in your community by searching online and checking the yellow pages, local teaching hospitals, and universities. Ask your friends for recommendations.

Then, once you've found a knowledgeable and sympathetic gatekeeper, schedule a thorough tune-up to make sure your chassis is ready for the road ahead.

Routine screenings

Here are the basic preventive measures you can expect a doctor to prescribe for you, following guidelines from the medical establishment.

Baseline
The US Preventative Services Task Force recommends a colonoscopy at age 50; follow up as necessary.

Semi-annual
The American Dental Hygienists recommend a dental exam and teeth cleaning.

Annual

Height, weight and blood pressure; check the Merck Manual.
Mammogram recommended by the US Preventative Services Task Force
Pap smear recommended by the American Cancer Society (perhaps less often if you've had three clear tests in a row)

Every 3-5 years
Cholesterol and blood sugar checked; American Diabetes Association and American Academy of Family Physicicans

Looking after special parts

Right at the half-century mark, age 51, the average American woman experiences menopause. Some symptoms, like hot flashes, should ease as the body adjusts to the end of its fertile period. Post menopausal conditions, like vaginal dryness, may persist. Consult with your doctor about the risks you might face with hormone replacement therapy and consider alternatives like dietary supplements (calcium and vitamin D for strong bones) and vaginal lubricants. Check out Our Bodies, Ourselves: Menopause for more.

In addition, your primary care physician will perform and recommend specialized exams to keep various bodily parts up and running after 50 years of wear and tear.

Eyes. You should see an ophthalmologist every year who will check your vision and be on the lookout for cataracts. Dr. Marguerite McDonald of Ophthalmic Consultants of Long Island, Lynbrook, N.Y., says women are particularly susceptible to dry eyes because hormonal changes impact the tear film coating the eye, making it drier. The dry, gritty feel and redness can make you miserable, but it's easily treated. The American Academy of Ophthalmology recommends eye exams every 2 years, but Dr. McDonald told me every year.)

Ears. Were you at Woodstock? Rock concerts in the '60s may have hurt your hearing. The Better Hearing Institute says about 14 percent of people ages 45-64 have some hearing loss. You should get screened at age 50 and every three years thereafter. Check with the American Speech Language Hearing Association.

Skin. Half a century of exposure to the sun is rough on your skin. Check yourself for suspicious changes. Ask your partner to check your back side. Have your doctor look you over thoroughly every year for changes in moles or scaly patches that could develop into cancer. Check with the American Cancer Society.

Thyroid. The symptoms of hypothyroidism (an overactive thyroid) are very subtle: feeling cold, dry skin, weight gain, constipation, fatigue, forgetfulness, hair loss, and depression. Have your thyroid screened at age 50 and every five years thereafter. Check out the American Thyroid Association.

Immunizations. If you think shots are just for rug rats, think again. You should start getting a flu shot every year at age 50. And get a tetanus-diphtheria booster every 10 years. There's a handy Adult Immunization Schedule online. If you travel to exotic or far-away places, also be sure to check the Centers for Disease Control Web site and ask your doctor how to get the inoculations you might need.

Of course, in addition to these measures, try to keep destructive forces such as smoking, overeating, inactivity, excessive alcohol, and lack of sleep in check. Get help if you cannot do it on your own; start by asking your doctor's advice.

For a convenient crib sheet on all the tests you should be taking and when, print out these Adult Health Maintenance Guidelines from Blue Cross/Blue Shield.

Getting screened on schedule should actually help you minimize the time you spend at the doctor's office. It will provide peace of mind and help you fine tune your health habits to maximize your vitality throughout your 50s and beyond.