If you request a complete - or executive - physical, you should expect your physician to do more than listen to your heart and lungs. In fact, a complete physical should include a wide range of tests depending on your age and gender - such as chest x-rays, audiograms, EKGs, laboratory tests, heart stress tests, pulmonary function testing, CAT scans, urinalysis, mammograms, prostate exams, vascular age tests.
One of the most important steps in a complete physical is the first one - discussing your recent medical history with your physician. If you have concerns, are experiencing symptoms or have questions about preventative tests or measures - now is the time to be forthright. After all, what you do - or don’t - tell your physician plays a role in the examination. If you’re experiencing tenderness - tell and show your doctor. Bothered by headaches, indigestion, an inability to sleep, shortness of breath, excessive fatigue? Tell your doctor. After all, who better to know what constitutes ‘normal’ for you and what is indicative of change, than you? I also recommend that you speak with your significant other or family members or friends with whom you live. They can point out things that might not be as obvious to you - physical traits or symptoms that you have simply “gotten used to” that may be worth a mention to your physician.
Generally speaking, the exam will start with an external assessment in which your physician looks to see if there are any abnormalities.
• Weight
• Height
• Pulse and blood pressure
• Temperature
• Skin color, scars or abnormalities
• Volume of breath on inhale/exhale as well as movement of your abdomen while respirating
• Tremors
Your physician will also palpate portions of your body and tap on the surface of your chest or abdomen. These exams help the physician check for edema, measure your pulse, and find painful or tender areas. When the doctor taps on your abdomen, for example, he or she is listening for a dull sound indicative of a solid mass or unhealthy tissue. These tests can also help determine if an organ is enlarged.
The physician should also listen to your heart - checking heart rate and listening for abnormal sounds that indicate a heart murmur or other conditions - and your gastrointestinal system. When listening to your lungs, the physician is trying to identify any wheezes or crackles.
Depending on your age and gender, your medical history and the concerns you relate to your physician, the aforementioned exams will be recommended as necessary.
A complete blood workup is also generally recommended. Abnormally high or low counts of white or red blood cells or platelets can alert your physician to some forms of disease. Other counts, such as glucose tolerance or cholesterol also give a good picture of your overall health status and what lifestyle changes are needed if excessively high or low values are found.
A number of lab tests can be run for a complete blood count. Following is a list of the test and what risk factor is being assessed:
• Albumin/Globulin Ratio - Renal and other chronic diseases
• Alkaline Phosphatase - liver and/or bone disease
• ALT (SGPT) - liver disease, jaundice
• AST (SGOT) - heart or liver disease
• Bilirubin - liver function
• Blood urea nitrogen (BUN) - liver and renal function
• BUN/Creatinine ratio - renal function
• Calcium - parathyroid function and calcium metabolism
• CBC (complete blood count) includes:
o Red blood cell count
o Hemoglobin
o Hematocrit
o Red blood cell indices
o Mean corpuscular hemoglobin
o Mean corpuscular hemoglobin concentration
o Red blood cell distribution
o White blood cell count
o Differential count
o Platelet count
• Cholesterol - risk for coronary heart disease
• Creatinine - renal function
• Fasting glucose - diabetes
• HDL Cholesterol - heart disease
• Iron - anemia and hemochromatosis
• LDH (Lactic dehydrogenase) - indicative of injury or disease
• LDL Cholesterol - heart disease
• Phosphorus
• Potassium - electrolyte balance, especially for those with cardiac disease
• Prostatic Specific Antigen - prostate cancer
• Protein/Albumin/Globulin - diseases that affect blood proteins
• Sodium - fluid and electrolyte balance
• Total Cholesterol/HDL Ratio - coronary heart disease
• Triglycerides - coronary heart disease or fat metabolism disorders
• Uric acid - gout
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