Adult Guidelines


Working with your health care provider to stay well is as important as getting treatment when you are sick. Please read this carefully and follow its recommendations. These tests and recommendations don’t guarantee health but may help us to identify problems early in hopes of prevention and cures.

Blood pressure

Maintaining a good blood pressure will help protect you from heart disease, stroke and kidney problems. Have your blood pressure checked regularly to establish what is normal for you. In general a blood pressure of 120/80 or less is acceptable for most adults. Eating low fat, low salt healthy foods and getting regular exercise of at least 30 minutes three times a week as well as keeping your weight near normal is usually adequate. Sometimes medications are added to lower blood pressure. If you check your own blood pressure, keep a written list of your readings and bring it with you to every visit. Never stop your medication or change the dose without talking to your health care provider.


Prevent serious disease by keeping up on the following immunizations.

  • TETANUS-DIPHTHERIA – Booster is needed every 10 years.
  • PNEUMONIA (pneumovax) – Initial immunization is needed prior to age 65 and a booster is needed at age 65 (at least 5 years after the initial immunization.) This immunization is vital for patients with the following conditions.
  • FLU (influenza) vaccine – This vaccine is recommended annually for everyone over age 65 and those considered at high risk (see list above). However anyone wishing to be protected may receive the vaccine.
  • HEPATITIS B – three immunizations are administered over a six month period. This immunization is highly recommended for all health care workers or anyone who may come in contact with others blood or body fluids, such as in unprotected sex or IV drug use.
  • RUBELLA – Any woman considering pregnancy who has not had an MMR vaccine.


Every adult should be screened yearly. If your cholesterol is high (over 200) or your LDL (bad cholesterol) is high (over100) diet and exercise may help. There are prescription medications that can help lower your cholesterol but will require regular monitoring with blood tests. There are some new grocery items to help lower cholesterol. Look for Benecol in the butter section of the grocery store, it may help.


One of the biggest problems in our society is being overweight. Numerous health problems arise when you are obese. If you are more than 30 pounds over your ideal body weight, your risk of cancer, arthritis, hypertension and diabetes increase dramatically. Exercise and healthy nutrition are the keys. There are medications that can help, but should never be used without a healthy diet and regular exercise. Medications require close monitoring, usually with monthly visits.

Heart Disease

Annual checkup should include an EKG after age 40. You should also have a TREADMILL EKG test performed about every five years after age 50. If you have a strong family history of heart attack, stroke or other cardiovascular disease you should talk to your health care provider about other preventive measures. Taking 81 mg of coated aspirin every day, as well as folate 400 mcg (0.4mg.), vitamin E 400 units, vitamin C 500 – 1000 mg, vitamin B6 3 mg, and vitamin B12 200mg decreases your risk for heart attack and stroke by 25-35%. These vitamins also may reduce your risk of cancers such as colon cancer.

Stroke Prevention

Control your blood pressure, keep your cholesterol and weight low, and take an 81 mg. aspirin a day. It is also very important to stay well hydrated and to get regular exercise.


Excellent prenatal care is vital to a healthy pregnancy and a healthy newborn. It is important to start your prenatal vitamins prior to becoming pregnant. In addition, taking folate (folic acid – 400 micrograms a day) can greatly decrease the risk of neurological birth defects. Don’t smoke, drink alcohol, or do any drugs. Be sure any medication you take is safe for pregnancy.

Colorectal Cancer

Colorectal cancer is the third leading cause of cancer deaths. It is important to notify your provider if you have blood in your stools, unusual changes in bowel habits or unexplained weight loss.

Recommended screening test include

  • Fecal occult blood test – annually after age 40
  • Sigmoidoscopy and a barium enema or colonoscopy – every five years after age 50

If you have a strong family history of colon cancer or polyps you may need earlier or more frequent screening.

Prostate Cancer

Men should have a digital prostate check and a PSA blood test every year starting at age 40. Saw palmetto and several prescription medications seem to help men urinate that have enlarged prostate glands but don’t protect against prostate cancer.

Testicular Cancer

Men age 15 – 35 are at highest risk. Men should do regular self exams and tell your health care provider about any suspicious changes.

Breast Cancer

All women should do monthly breast self exams, best done right before your period. Opinions vary, but it would be wise to get your first mammogram at age 35. Women with strong family history of breast cancer should start earlier than that. Annual mammograms after age 40 are a must.

Pap Smears

A simple test that has saved many women’s lives. All women age 18 and older, or any sexually active teenager should have a pap smear performed annually. Women who have had hysterectomy may not need the test as often, but the pelvic examination is important and should still be performed annually to check for other diseases of the pelvis.


All women who are at or past menopause or have had their ovaries removed should be screened by a simple bone density test. 1500 mg calcium with 800 mg vitamin D along with estrogen and regular exercise helps to prevent bone weakening. There are medications available to increase bone strength if needed. If you take medication for osteoporosis you should have your bone density rechecked every 1-2 years. Talk to your health care provider for details.

Tobacco Use

Tobacco use in any form is dangerous to your health, the health of those around you, and is expensive. There are pills, patches, gums, etc. to help you stop but the best thing is for you to just quit. If you want to and just can’t, talk to your health care provider.


Do you feel sad, tired all the time, tearful, can’t sleep, nervous, and just not enjoying things you used to enjoy? You may be depressed. But the good news is that there are good treatments available. Your mental health can affect your physical health. Common symptoms include migraine headaches, irritable bowel syndrome, fatigue and insomnia. If you feel that you may be depressed, discuss your symptoms with your health care provider.


Unprotected intercourse puts you at risk for several serious diseases. The best way to protect yourself is to:

  • Don’t have sex.
  • Have sex with only one, mutually faithful, uninfected partner.

If you think you may be at risk, ask for an STD (sexually transmitted disease) screening exam. There are good treatments available if you should be infected. Don’t be afraid to ask. Parents need to speak with their children early and often regarding the dangers of unprotected intercourse.


You should be screened annually. Symptoms of diabetes are: unexplained weight loss, excessive thirst, excessive urination, and wounds that won’t heal. If you have a strong family history of diabetes or you are overweight you are at higher risk and may require more frequent blood checks. If you have diabetes you should follow a strict diet, keep your weight under control, get annual exams of your eyes, heart, kidneys and watch for signs of infection, numbness or pain that could mean more serious problems.


If you drink alcohol, do so only in moderation – no more than one drink a day for women and two drinks a day for men. Never drive after drinking.

Sun Protection

It is very important that adults use sun block regularly. SPF of 30 is the minimum amount of protection recommended. Remember to apply sun block early and often especially after swimming and exercise keeping in mind that the most dangerous hours of sun exposure are between 11:00 am and 3:00 pm.

Vitamins and Herbs

Vitamins and minerals in proper amounts are good and healthy. Some herbs are also beneficial but some may be harmful. Always notify our staff about any vitamins, minerals or herbs you are taking and the amounts. Some helpful hints:

  • If you are over 45 you should get: 1200 mg of calcium and 400 mg of vitamin D, Aspirin 81 mg, folate 400 mg, B6 -200 mg, B12 -200 mg daily.
  • Avoid mega doses of Vitamin A, zinc and iron.
  • Smokers should avoid Beta Carotene.
  • Pregnant women should take folate 1 mg daily.
  • Essential minerals that should be in your multivitamin are: copper, iodine, magnesium, phosphorus, and zinc.
  • Vitamin E 1200 units per day with food also help prevent macular degeneration and helps memory.
  • Vitamin C 500-1000 mg per day is reported to have numerous benefits.
  • Some herbs that have shown promise are: Saw Palmetto for prostate enlargement, Chondroitin/Glucosamine for arthritis: 100 mg for each 10 pounds of body weight, Ginkgo Biloba for memory loss, Echinacea for colds and flu, Garlic for cholesterol and blood pressure, Feverfew for migraine headaches, St. John’s Wort for depression, Kava Kava for anxiety, Ginseng for stress, Melatonin for sleep and Black Cohosh for menopause symptoms. Remember these medications are not regulated or tested by any agency and are considered nutrition supplements. The exact doses and side effects are not well known and their mechanism of action is not known. Take them at your own risk but be sure you tell us if you are taking any of them.