Healthy Living: Your Roadmap to Wellness

Pittsburgh doctors offer advice on the best ways to live better today for a healthier lifetime. 
Wellness

PHOTOS: SHUTTERSTOCK

The suggestions in this article are general in nature. They do not apply to every person in every case and do not replace an annual personal consultation with a healthcare professional.

This advice covers everyone at every stage of their life.

NEWBORN TO 10 YEARS

Newborn

Babies, from the moment they are born until they toddle out of their parents’ arms, receive the most medical intervention of all age groups, with doctor’s check-ups coming nearly every two months in the first year of life.

0-6 months

  • Birth – Baby’s first few days in the world should be spent bonding with parents and undergoing important tests for issues including jaundice, blood disorders and congenital heart defects as well as vision, hearing, weight, height and reflexes screenings
  • Dental Care – Parents should begin brushing baby’s teeth twice a day, as soon as they begin appearing (around six months)
  • Well-Child Visits – Recommended for infants at 1 month, 2 months, 4, 6 and 9 months, and continuing annually until the age of 10, these exams performed by a pediatrician consist of listening to vital organs; palpating and tapping different areas of their bodies; testing vision, hearing and reflexes; and monitoring height, weight and temperature. Baby will also receive immunizations.

9 months
The CDC recommends a developmental and behavioral screening as part of the well-child visit where caregivers are asked questions about language, movement, thinking, behavior and emotions.

1 year
Nutrition

At this well-child exam, parents should discuss establishing a proper diet and healthy eating habits for their growing baby. This may include transitioning their child from breast milk or formula to whole milk and starting or increasing baby’s solid food intake.

Dental
According to the American Dental Association, children should have their first dental check-up within six months of getting their first tooth.  Visits, which help familiarize baby with the dentist, include an oral exam to determine tooth health and identify potential cavities/decay; a tooth cleaning and lesson on oral hygiene; discussion about pacifier-use/thumb-sucking.

18 months
American Academy of Pediatrics recommends conducting an initial Autism Spectrum Disorder screening, to be repeated at 2 years of age and older if indicated.

5 Year Old

2-10 years
Continue annual well-child visits and regular dental check-ups

– Bright Futures/American Academy of Pediatrics

Milestones

2 months
Tries to look at parent, pays attention to faces

4 months
Mimics facial expressions, responds to affection

6 months
Likes to look in the mirror, brings objects to mouth

9 months
Has favorite toys, picks up small items between thumb and forefinger

Tenyearolds

12 months
Puts out arm or leg to help with dressing, follows simple directions

18 months
Explores alone if a parent is nearby, can point to a body part when asked

2 years
Gets excited to see other children, begins sorting shapes and colors

3 years
Can dress self, completes puzzles with three or four pieces

4 years
Can tell the difference between real and make-believe, predicts what will happen next in a book

5 years
Wants to be like their friends, can draw a person with six body parts

— Adapted from HealthyChildren.org

ADOLESCENTS – 11-19

Teenagers

The good news about this age group is that it’s the healthiest decade of life, says the Squirrel Hill Health Center’s Dr. Deborah Gilboa, who is also a noted parenting and youth development expert, which is why it is critical to focus on preventive medicine with adolescents. “When you get something that’s in peak condition, you’ve got to learn how to keep it that way as long as you can,” she adds.

Things to watch out for in the teen years:

  • Obesity
  • Mental health issues
  • Tech overuse
  • Substance abuse

“What kills people in the second decade of life overwhelmingly is bad luck and bad judgment,” she explains. “We can mitigate bad luck with good choices, but there are some things that just are not your fault and are not controllable. But bad judgment, that we can help.”

How best to help? “Talk to them about stuff they probably don’t want to talk about. Over and over again,” Gilboa says. Even if it means a lot of eye-rolling. The mother of four sons ranging in age from 11 to 18 also recommends encouraging adolescents to develop good decision-making skills as they become more independent.

“We have to be in ‘Teaching them to fish mode’ and not the ‘fishing for them’ mode,” Gilboa adds.

While adolescents’ bodies are generally healthy at this point in their lives, it’s imperative for parents to pay attention to their child’s mental wellness. Doctors screen for mental health issues at annual appointments, but relying on medical professionals to identify potential concerns isn’t enough. “We should be encouraging our kids to have communicative relationships with us,” as well as other adults and peers who have their best interests in mind, Gilboa says.

She also outlined three skills that help strengthen adolescents’ mental health:

  • Developing the ability to tell true stories about your own experiences, which helps a person recognize the perspective of others and express their emotions in socially acceptable ways that build empathy;
  • Building the skills to solve problems themselves;
  • Knowing how to reach out for resources and ask for and get help when it is needed.

Two topics that have an enormous impact on teens’ mental health are gender and sexuality. “We’ve got to be asking these kids about their gender as well as their sexuality,”
Gilboa says, because adolescents who are questioning either of these things are at higher risk of self harm.

In addition:

  • American Academy of Pediatrics recommends teens see their physician annually for an exam during which they should receive additional vaccinations or boosters for shots received in childhood. One vaccine offered for the first time in adolescence is the HPV vaccine, which protects both young men and women against the human papillomavirus, which can cause cancer and genital warts.
  • Adolescents should also receive regular vision screenings and twice-annual dental exams and cleanings. Some may be referred to an orthodontist to address irregularities in bite or tooth spacing, and they may be required to wear braces to correct the issue. Many teens will also need to have their third molars or “wisdom teeth” removed at this time.

WOMEN

Womengroup

The Greatest Gift Women Can Give Themselves is a Women’s Health Physician

Women’s preventive health care is a complex maze of needs and requirements that in many ways takes twists and turns based on their reproductive cycles.

Of utmost importance to their ongoing health and wellness, says Dr. Beth Prairie, OB/GYN with Allegheny Health Network’s West Penn Hospital, is for women to regularly see a women’s health physician whom she can trust and is familiar with health care guidelines established by the Women’s Preventive Services Initiative. The WPSI is a coalition of national health professional organizations, including the American College of Obstetrics and Gynecology and consumer and patient advocates with expertise in women’s health who develop, review, and update recommendations for women’s preventive healthcare services.

Healthy Considerations for Women of Every Age

While women’s preventive health needs change throughout their lives, Prairie does have some recommendations that cross all age groups.

  • Stay up to date on your immunizations and screenings
  • Make your reproductive goals clear and discuss them with your women’s health provider
  • Eat a balanced diet
  • Sleep well
  • Have adequate calcium intake in your diet
  • Achieve and maintain a healthy weight
  • Move your body every single day
  • See a physician or other health-care provider at least once a year
  • Spend time with people who love you, support you and make you laugh

For young women just beginning their reproductive journey, ages 13-21, the emphasis is on:

  • Screening for general health concerns including obesity, nutrition and physical activity
  • Education about consent, sexuality and substance abuse as well as “good conversations about safer sex practices and reproductive planning and contraception,” Prairie says.
  • Screening for sexually transmitted infections annually at a minimum
  • Preventing unintentional injury

Women in this age group should get the HPV vaccination, which protects against cancer, if they haven’t already had it.

As women move into the 22-39 age group, health care professionals want to work with women to help them maintain and achieve a healthy weight and healthy level of physical activity, continue discussing substance use, make sure they are safe in their homes and relationships and ensure they have adequate access to contraception and contraceptive counseling as well as screening for STIs and cancers as needed.

For women who are considering having children, adding folic acid supplements to their diets is an important step, as is having a pre-conception visit. “If a couple is trying to conceive, a woman’s health care provider can help intervene early if there are difficulties with conception and can help get women who are at a higher risk of pregnancy complications into the care that they need in anticipation of a pregnancy and during a pregnancy,” Prairie adds.

50 Year Old Women

At around age 50, Prairie advises that women would be well-served to have both a primary care physician and OB/GYN or ensure their health care provider is well-versed in women’s health. “At around age 50, many of the guidelines for preventive services change — what immunizations you need, what blood tests you need, colorectal cancer screening, etc. These are things that can be challenging for a single provider to do in a single visit a year, along with planning for healthy aging, getting through your menopausal transition and any other needs you may have.”

Recommended Preventive Health Care for Women Age 50-64

  • Screening for tobacco use, blood pressure, depression, lipid disorder, domestic violence, obesity and urinary incontinence
  • Update all immunizations
  • Test for infectious diseases including Hepatitis C and HIV
  • Screen for breast cancer and conduct risk assessment for BRCA testing
  • Continue cervical cancer screening via pap smears
  • Begin colorectal cancer screening

At age 65 and older, women should also be screened for osteoporosis and educated on mitigating the risks of falls.

— Women’s Preventive Services Initiative

On the Rise
Sexually transmitted infections are on the rise in the U.S. For younger women, chlamydia is the most common sexually transmitted infection, discounting HPV. STIs are also on the rise in the senior population. “Practicing safer sex, which starts with talking to your partner, is crucially important, not only for women’s health, but for men’s health as well,” says Prairie.

Clearing up the Confusion
According to Prairie, many women are confused about how often they should get a pap smear, which is a procedure that tests for cervical cancer.  While women may have an annual pelvic exam by a women’s health care provider, “not all pelvic exams are pap smears and most women don’t need a pap every year,” she adds. She recommends speaking to your physician about the frequency of testing right for you.

MEN

Checkup

Prevention begins in the Doctor’s office

At an annual exam, men ages 18–39 should expect:

  • Discussion of weight, physical activity and nutrition
  • Instruction in male hygiene/self-exam
  • Counseling on substance abuse including tobacco, alcohol, anabolic steroids, supplements and stimulants
  • Discussion on sports safety
  • Review of family history and risk factors
  • Mental health evaluation and discussion of PTSD and suicide
  • Testicular cancer exam/self-exam
  • Screenings for hypertension, lipid profile
  • Discussion of sexual activity, contraception, screening for STIs
  • Information on urologic cancer
  • Skin cancer examination

When men hit their 40s, the need for screenings and medical intervention increases. “Depending on their family history, their race, their cancer history, this is the time when men may need to start having prostate cancer screenings much earlier than your average population, and a lot of guys don’t know that,” Dr. Kathleen Hwang says. “If their uncle, or father or first-degree relative had prostate cancer, they’re at elevated risk and should be screening earlier than not.”

In addition to the regular screenings and tests outlined, men in the 40-49 age group should also have a full skin cancer exam, colorectal screenings in some cases and fasting blood sugar and other blood work as needed.

50 Year Old Man

If they didn’t fall into a high-risk category in their 40s, men in the 50-69 age group should definitely prepare for colorectal and prostate cancer screenings, along with a discussion about urologic cancer, diabetes screening, eye examination and possible vascular ultrasound to rule out an abdominal aortic aneurysm.

Men in their 70s and older will also have bone health and mobility exams done. But, they may not have to undergo regular prostate screening, says Hwang.

Hwang recognizes that for men, seeking help and continuing treatment might be difficult given society’s pre-disposed ideas of manhood. But she urges that men from teens to their twilight years take an active role in their health and wellness and reach out for help if they need it. “The hardest thing for men to do is to take that first step and to ask for help. And I think what we as health care providers need to do is make it more accessible.”

— Men’s Health Checklist (American Urological Association)

Dr. Kathleen Hwang knows that men aren’t always the best at prioritizing their health care needs. Men are really good at taking care of others, she says, “but maybe not as good at helping themselves.”

The director of Men’s Reproductive Health at UPMC’s newly created Men’s Health Center in the Kaufmann Building on the University of Pittsburgh campus has figured out the one thing that will get men and their partners in her office, and she’s capitalizing on that knowledge to help them lead an overall healthier life.

Half of all men ages 40-70 have some sort of erectile dysfunction and want to seek care for the condition, Hwang notes. And when they do, if they’re coming to her center, they will be met by a knowledgeable and discreet staff dedicated to resolving the primary issue, as well as any chronic illnesses or underlying concerns that might be its root cause.

She outlines a number of things that men can do throughout their lifetime to avoid chronic illness and stay healthier longer. And they start, not surprisingly, with an annual visit to the doctor.

“The reality is you go see a pediatrician every year growing up, then you turn 18 and the next time you see a doctor you’re in your 40s. So, there’s like, two decades where nobody is being evaluated,” she says. Without someone tracking weight, blood pressure, waist circumference and calculating BMI, men are missing an opportunity to see bad habits developing and stop them before they turn into more challenging issues.

Healthy Living

9 Simple Tips for Living Healthy

Not all preventive medicine is created equal. For example, a colorectal exam is much more complicated than having your blood pressure checked once a year. Dr. Hwang shares some relatively easy things men can do every day to get healthy and stay that way.

“These are easy for me to say, but it is actually very challenging to make lasting changes to your lifestyle,” admits Hwang. “But they have such potential for keeping you healthier longer.”

  • Practice safer sex
  • Protect your skin, use sunscreen, wear a hat
  • Don’t smoke
  • Exercise regularly
  • If overweight, make losing weight a priority
  • Be active
  • Protect your testicles, wear a cup
  • Get an annual check-up
  • Ask for help

Things Every Adult Can Do to Stay or Get Healthy
According to the National Center for Chronic Disease Prevention and Health Promotion, a few risky behaviors, including smoking, consuming too much alcohol, leading a sedentary lifestyle and poor nutrition, are the causes of many chronic health conditions, such as heart disease, cancer and diabetes. The organization, a part of the Centers for Disease Control and Prevention, with a budget in excess of $1 billion in 2019, works to help people and communities prevent chronic diseases and promote health and wellness nationwide.

The organization recommends these 8 actions every adult can take to manage their health and prevent chronic disease:

  1. Quit Smoking
    Smoking causes serious health problems, including heart disease, cancer, Type 2 diabetes and lung disease, as well as premature death.
  2. Watch What You Eat
    A healthy diet helps prevent and manage heart disease, Type 2 diabetes and other chronic diseases. If overweight, losing even 5-7% of body weight can help prevent or delay Type 2 diabetes.
  3. Be Active
    Getting at least 150 minutes of routine exercise a week can help prevent, delay and manage chronic illness.
  4. Reduce Alcohol
    Excessive drinking can lead to high blood pressure, various cancers, heart disease, stroke and liver disease.
  5. Get Regular Check-Ups
    Seeing a health care provider regularly can prevent chronic diseases or catch them early.
  6. Get Enough Sleep
    Insufficient sleep has been linked to diabetes, heart disease, obesity and depression.
  7. Know Your History
    You are more likely to develop some chronic diseases, including cancer, heart disease, diabetes or osteoporosis, if you have a family history of it. Share your family health history with your doctor, who can help you take steps to prevent these conditions or catch them early.
  8. Make Healthy Choices
    Making healthy behaviors part of daily life can prevent conditions such as high blood pressure or obesity, which raise the risk of developing the most common and serious chronic diseases.

VACCINES SAVE LIVES

Vaccines

According to UNICEF,  vaccinations prevent 2 to 3 million deaths worldwide annually.  They not only protect those receiving the immunizations but also vulnerable populations such as newborn babies and immune-suppressed people who have not been, or are unable to be, vaccinated.

Lifetime Vaccination Schedule

DTAP – Diphtheria, Tetanus and Pertussis
5 total doses

  • 2 months
  • 4 months
  • 6 months
  • 15-18 months
  • 4-6 years

Tdap – Booster for DTAP

  • 11-12 years
  • Td or Tdap booster every 10 years

HepA – Hepatitis A
Two total doses (six months apart) between the ages of 12 months and 23 months

HepB – Hepatitis B
3 total doses

  • birth
  • 1-2 months
  • 6-18 months

Hib – Haemophilus Influenzae Type b
3-4 total doses

  • 2 months
  • 4 months
  • 6 months
  • 12-15 months

HPV – Human Papillomavirus
2 total doses (within a six-month period) between the ages of 11 and 12 years for everyone

Influenza
2 total doses (four weeks apart) between 4 and 6 months within the first year; 1 dose a year for everyone 9 years and older

MMR – Measles, Mumps and Rubella
2 total doses

  • 12-15 months
  • 4-6 years
  • May require booster as an adult

MenACWY – Meningococcal
2 total doses

  • 11-12 years
  • 16 years (booster)

PCV13 – Pneumococcal conjugate
4 total doses

  • 2 months
  • 4 months
  • 6 months
  • 12-15 months

PPSV23 – Pneumococcal polysaccharide
1 dose at age 65

IPV – Polio
4 doses total

  • 2 months
  • 4 months
  • 6-18 months
  • 4-6 years

RV – Rotavirus
2-3 total doses

  • 2 months
  • 4 months
  • 6 months

RZV – Shingles
1 dose beginning at age 60

Varicella (Chickenpox)
2 total doses

  • 12-15 months
  • 4-6 years

— Centers for Disease Control and Prevention

See vaccines.gov for more details and age-specific vaccination schedules and be sure to discuss any concerns or underlying medical conditions with a healthcare provider.

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