www.roanoke.com

Dr. Michael Camardi

Recent columns

• Age Matters: Dementia is a terminal illness
• Why I'm getting the flu shots
• Column archive

About Dr. Michael Camardi

Dr. Michael Camardi is a geriatrician at Carilion's Center for Healthy Aging. Age Matters is his new Roanoke Times column, appearing the third Tuesday of every month.

Camardi has been with Carilion for about three years and was one of the experts who reporter Beth Macy spoke to for her series, “Age of Uncertainty.” He wanted to start this column to help answer questions he’s often heard as part of his job.

Camardi was founder and past medical director of the geriatric liaison program for Jacobi Medical Center (Albert Einstein College of Medicine) in Bronx, N .Y.

Camardi trained at Winthrop University Hospital (Stony Brook University Medical School), where he was chief medical resident. He has received numerous commendations for his contributions to education, patient advocacy, community relations and hospital administration.

If you have questions for Camardi, please mail them to him at Center for Healthy Aging, 2118 Rosalind Ave., Roanoke, VA 24014, or e-mail them to extra@roanoke.com with “Age Matters” in the subject line.

Dr. Camardi: You were the one who took care of me when I was so bad over at Spring Tree when I was there for that bug I got in my chest. But when you sent me home, you told me that I had to go to my usual doctor so I could get some more tests for my yearly physical.

For the life of me with all the stuff they did to me in the hospital and all what you did, why do I have to go back for more tests? Because as of right now I've had enough of doctoring.

-- Bent Mountain

Often when we go into the hospital, we only get the most important issues -- those problems that made us sick enough to go the hospital in the first place -- taken care of. Many times all of the components of a complete physical examination are not covered.

What I would like to do is to discuss the key studies of what I feel a patient should have in their evaluation. Below is a list of the fundamental tests for a geriatric patient and why they are important.

• Blood pressure: What most people do not understand about high blood pressure is that it is a controllable condition that can damage anything that has blood flow to it -- and that's everything in our bodies, such as the brain, the heart, the kidneys, the eyes -- in short, anything you don't want to lose!

• Weight control: As some of you have thoughtfully mentioned when we have met, I have gained some unwanted pounds over the winter (I'll spare you the excuses) that I will promptly shed by eating less and walking more.

Increased weight makes blood pressure control all the more difficult, so I will limit the portions and the snacks and get on the treadmill for 30 minutes a day. I know you will all be kind enough to let me know how I'm doing!

• Cholesterol screening: Major advances in medications and diet have been made in lowering and controlling this leading cause of vascular disease. Get your total cholesterol, HDL, LDL and triglycerides checked. By the way, if you are confused about what HDL and LDL really mean, think about it as my older daughter did when she gave a "Show and Tell" on this in grade school: the "H" in HDL stands for the "happy" cholesterol and the "L" in LDL stands for the "lousy" cholesterol.

• Blood sugar: Diabetes does not have to ruin your life. Get a fasting blood sugar count once every two years, control your weight and stay active.

• Thyroid hormone blood test: Have this done every three to five years, as the early signs of thyroid disease are quite subtle (ranging from depression, fatigue, hair loss, weight gain or loss among others) but are controllable with medication.

• Total body skin exam: Most people receive the majority of their sun exposure before the age of 18, but skin cancers can take up to 20 or more years to manifest themselves. Have those moles and other skin lesions checked once a year. And wear sunscreen and a hat with a broad brim during sunny days.

• Dental exams: Gum disease is an important marker for your overall health. Go to your dentist yearly, brush with a fluorinated toothpaste and make sure to floss.

• Rectal exams and colon cancer screening: OK listen everybody, JUST DO IT. I did; I have to. Once it's over and done with, it's one less thing to have nagging at your conscience.

Can I tell you how bad I feel for people (more commonly, by the way, men) who, if they get colon cancer, just feel plain foolish because they passed up all those chances to catch it early.

Starting at the age of 50, a colonoscopy should be done every 10 years and more frequently and/or earlier if you have other risk factors. Talk to your provider about getting your rectal exam done and arranging for proper screening. And gentlemen, note that in this category men have all the luck -- you can get your prostate checked at the same time.

• Pelvic exams and Pap smears: Women over the age of 60 can still get cervical or vaginal cancer. And a Pap smear should be done every three years (do note that if a woman is over the age of 65 and has had a total hysterectomy or three consecutive negative Pap smears, a Pap smear does not have to be done).

• Breast exam and mammogram: Let me clear up another popular misconception and an urban legend: The risk of breast cancer does increase with age (not the opposite) and the mammogram does not cause cancer. Some women over time get into a fatalistic mind-set about this as they age: Do not let it happen to you! Once over the age of 40, a mammogram should be done every one to two years.

• Osteoporosis screening: Studies have demonstrated that patients who have osteoporosis and have suffered a fracture, especially involving the hip, are at a very high risk of permanent disability or death. This is a very serious public health care risk for both men and women.

• Vision testing: Over the age of 65, your eyes should be screened every one to two years for such conditions as macular degeneration, cataracts and glaucoma. Wear your sunglasses on bright days.

• Hearing tests: Get tested every two to three years as one-third of people over the age of 60 have a treatable source of hearing loss.

• Vaccinations: If you are over the age of 50, you should get a yearly flu shot and a tetanus booster every 10 years, along with a pneumococcal vaccination if you are over the age of 65.

• Drinking alcohol and smoking: If you do nothing else, speak to your provider about these two keys factors that you are in control of. Cut down on these activities and the result is a longer, happier and richer (have you seen the price of tobacco recently?) life.

The idea that we can go along with our lives and not do the important work of taking care of ourselves is childish. Some of us hide behind a little story we like to tell ourselves, that "it's really not all that important" and "whatever will happen is going to happen no matter what, so why bother?"

Well, I can tell you that the result of that thinking is a lot of self-blame, personal resentment and finger pointing when something does happen. Don't be a fool.

How do we get this all done? What reminders can we use to help us remember what we must do?

For me, I use that water-shed moment that happens every year -- whether I like it or not -- to remind us of our place in the universe: My birthday. Heck, after that little fast one must do for the cholesterol test, that birthday cake tastes all that much better!

Doing what should be done for ourselves and for our loved ones makes the celebration of our passing time on this Earth all the more meaningful, joyous and full of thanksgiving. Give yourself the one gift you can really use. Make that appointment.