1. Fill out and bring with you to your appointment OnLine Registration Forms. There are New Patient Forms for new patients and Established Patient Forms for returning patients. Be sure to fill out the correct forms.

2. If you know you need blood work before your Health Maintenance Exam [HME], call to have your fasting blood work scheduled two weeks before your physical.

3. If you DO NOT know if you need blood work, Do Not eat anything after 10:00 pm the evening before the physical.  You may bring your usual medications/supplements/snack to take after the blood work.

4. Bring your "Personal Health Record**"  to go over it with your provider.  Be sure to ask for a copy of your blood test.

5. Bring your list of questions.

6. Bring all your medications/supplements to go over with your doctor.

7. Immunizations:  Know the date of your last tetanus shot.  Adults should have one every 10 years.

8. Know your blood pressure [BP]:  Anything over 120/70 and under 140/80 is considered "PRE-HYPERTENSION" and should be addressed.  DON'T wait until your BP is consistently above 140/80!

9. Know your lipid values.  Cholesterol should be less than 200 [preferably 160-180] with LDL less than 130 [preferably less than 75 if you have coronary artery disease] and HDL greater that 45 for men greater than 55 for women!  It is imperative that you also know the INFLAMMATION marker hsCRP [high sensitive CRP] and keep it in the normal range.  In females, an elevated hsCRP is more predictive of an cardiac event than the cholesterol.  REMEMBER: 50% of all heart attacks occur in folks with NORMAL cholesterols!!!!!! 

10. If you have a family history or are genetically fair-skinned, yearly dermatological exams are advised.  Please remember "sun blocks" when you are out in the sun.

11. Cancer screening.  

    Females: Cervical:  Paps should be started when a young woman begins to participate in sexually activities or at the age of twenty-one...which ever comes first.  Paps check for HPV [Human Papilloma Viruses].  Your exposure comes from the prior exposure of your sexual partner(s).  Your ability to be infected and express  HPV depends on your immune system. High risk behavior for an Abnormal Pap include:             "RISKY BEHAVIOR"                                               RELATIVE RISK   Age at first intercourse(<18)                                                        2.76   Deficient diet intake of beta-carotene(<5,000 IU/day)                    2.814   Smoking(10+ cigarettes/day)                                                       3.06   Multiple sexual partners(2 - 5)or partner with multiple partners        3.46   Oral contraceptives(5 - 8 yrs)                                                      3.66   Deficient diet intake vitamin C(<30mg/day)                                   6.717 Pap's should be repeated yearly.  Any less often needs to be agreed upon by the doctor and patient. Breast: Mammograms:  Baseline at 35 with follow up at 40 if the initial exam was normal.  More often if your doctor suggests. Thermograms:  May be started earlier than 35 if desired or family history dictates.

    Males: Testicular Self Exams are just as important in men as Breast Self Exams are in women. If family history dictates screening procedures be started, talk with your physician.

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1. Fill out and bring with you to your appointment OnLine Registration Forms. There are New Patient Forms for new patients and Established Patient Forms for returning patients. Be sure to fill out the correct forms.

2. If you know you need blood work before you Health Maintenance Exam [HME], call to have your fasting blood work scheduled two weeks before your physical.

3. If you DO NOT know if you need blood work, Do Not eat anything after 10:00 pm the evening before the physical.  You may bring your usual medications/supplements/snack to take after the blood work.

4. Bring your "Personal Health Journal**"  to go over it with your provider.  Be sure to ask for a copy of your blood test.

5. Bring your list of questions.

6. Bring all your medications/supplements to go over with your doctor.

7. Dr. Schultz has a saying, "You get to 40 in spite of yourself.  You get past 40 because of yourself." For most of us our health is a gift! BUT if we plan on living healthfully into our 80's, we need to put some purposeful planning into staying healthy.

   *If you have made it to middle age, the following are some factors that may have got you there:

   	Ancestral longevity
   	Cholesterol
   	Stress
   	Parental characteristics
   	Childhood temperament
   	Vital affect and ease in social relationships

   *BUT if you plan on living into your 80's as a Happy Well person, the following factors predict your ability to do so:

   	NOT SMOKING or stopping by the age of 45
   	Adaptive coping style
   	Absence of alcohol abuse
   	Healthy weight
   	Stable marriage
   	Some exercise
   	Years of education-the more the better!

   Cancer screening.  

   Females: Cervical:  Same as "Female < 40" Breast: Mammograms:  Baseline at 35 with follow up at 40 if the initial exam was normal.  Then every 2 to 3 years as your physician suggests. Thermogram : Yearly from thirty if you have a strong family history of breast cancer BSE - Breast Self Exam:  You do this at home...once a month the week after your menses.  If you find anything you have never felt before, schedule an appointment with the doctor to examine you. Colon:  Fecal Occult Blood Test and rectal are done in the office during the physical.  Further testing is dependent on physical findings and family history.

   Males: Digital Rectal and Prostate Exam with PSA:  At this age, if you have a parent or grandparents with prostate cancer, you will need a blood test to screen for prostate cancer to determine frequency of testing during this age group. Testosterone Level: Since declining testosterone can be associated with increasing lipids, depression and Type II Diabetes, it is important to know your values and treat them when they begin to wane. Don't wait for the diseases to start.   Colon:  Fecal Occult Blood Test and rectal are done in the office during the physical.  Further testing is dependent on physical findings and family history.

1. In addition to the "Female and Male > 40 / <50 "

2. Be sure to maintain the following:

   	DO NOT SMOKE
   	DO NOT ABUSE alcohol
   	Continue or acquire adaptive coping styles
   	Healthy weight
   	Stable marriage
   	Some exercise
   	Continue education-the more the better!

3. NEWS advises yearly Fecal Occult Blood Test with Calprotectin screening for inflammatory/neoplastic bowel disease as indicated.  The interpretation of these tests and family history dictates further therapies.  These may include:

   	flexible sigmoidoscopy
   	barium enema
   	genetic testing
   	colonoscopy
   	virtual colonoscopy

4. Have hearing and sight tested.  Make corrections as indicated.

5. Cancer Screening:

   	Female: Mammograms, as noted in "Female over 40" should now be yearly.
   	Male: A yearly Digital Rectal and Prostate Exam with PSA (cancer screening blood). Testosterone Level: Since declining testosterone can be associated with increasing lipids, depression and Type II Diabetes, it is important to know your values and treat them when they begin to wane. Don't wait for the diseases to start.

6. Immunizations:  

   Know the date of your last tetanus shot.  Adults should have one every 10 years.

7. Females and Males, know your Bone Density status!  Take action now so Osteoporosis does not slow you down or end your life!  

   	Bone Densities are available on-site @NEWS.
   	Dr. Schultz was the first physician in Northeast Georgia to own and routinely use DEXA studies on her patients before it was a fad and before there were pharmaceuticals to treat the "disease".

8. Scientific studies have proven aspirin reduces risk of heart attacks and strokes. We recommend you start taking a low dose adult aspirin | 81mg for men [starting at 50yo] and 162mg for women [starting at 65yo] for the rest of your life. 

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Revised last: 2/2008