Elderly health checkup package

Not at all. The core of a physical examination package that is truly suitable for the elderly is "full coverage of basic necessary items and precise addition of high-risk items." The total price is mostly between 1,500 and 3,500 yuan, which can cover more than 80% of the needs for early screening of high-risk diseases in the elderly. For high-end packages that easily cost tens of thousands of yuan, 90% of the items are unnecessary IQ taxes.

I just met an aunt last week. My son Xiaoshun bought me a luxury package worth nearly RMB 20,000, including a PET-CT and a whole-body genetic test. The results did not even include the most basic 2-hour postprandial blood sugar. The aunt had symptoms of polydipsia and polyuria. In the end, I asked her to take an extra fingertip blood test, and then I found out that she had reached the critical value of diabetes. I spent more than RMB 10,000 before, and half of the money I spent didn't cover anything.

Don’t think that the basic items are just a make-up. Each item here is the gold standard left behind by clinical screening for decades: hematuria and stool routine, liver and kidney function, fasting + postprandial blood sugar, glycosylated hemoglobin, blood lipids, electrocardiogram, abdominal ultrasound, and urinary tract ultrasound. These are all must-have items. Oh, by the way, there is also lung screening. There are actually some differences in the academic community: one group advocates that those over 60 years old should directly undergo low-dose chest CT regardless of whether they have a history of smoking or oil fume exposure. The sensitivity of early screening is much higher than that of chest X-ray; the other group believes that the elderly without high-risk factors should first undergo a regular chest X-ray, and then follow up with CT if there are abnormalities, which can reduce exposure to point radiation. My own experience is that if the elderly at home often cough, or have smoked for 20 or 30 years, don’t hesitate to directly add CT, there is no harm.

The basic items are the basics, but the additional items really vary from person to person. Don’t listen to the “family-friendly add-on package” that the salesperson recommends to you. You have to pay attention to the elderly’s past medical history and daily discomforts. For example, if you have high blood pressure and often feel dizzy and have headaches, don’t just measure blood pressure in the clinic, but also measure 24-hour ambulatory blood pressure, homocysteine, and carotid artery ultrasound. I once met an old man whose blood pressure was normal every time he measured it at home. But when he did the dynamic test, he discovered that his blood pressure soared to 180 at two o’clock in the morning. He didn’t feel anything. If he hadn’t checked this, he might have had a cerebrovascular accident one night. Another example is female elderly people. Don’t think that you don’t have to worry about gynecology after menopause. Before the age of 65, TCT, HPV and breast ultrasound must be checked regularly. Last year, our center screened out 3 cases of early-stage cervical cancer, all of which were aunts in their 60s. They had never had a gynecological examination before. Fortunately, they were discovered early and were cured and everything was fine.

Having mentioned this, I have to mention the most common pitfalls: "full set of whole-body tumor markers", "gene testing for cancer detection" and "PET-CT whole-body screening". These are the IQ tax items with the highest premium in the package. Don’t believe it. Elevated tumor markers do not mean cancer at all. Inflammation, a cold, or even eating too much oil the day before may cause the values ​​to rise. On the other hand, normal indicators may also indicate early-stage cancer. Checking this alone will do nothing but make you worry. Of course, this does not mean that tumor markers cannot be checked at all. If there is a clear family history of cancer in the family, for example, if an immediate relative has liver cancer, then add alpha-fetoprotein in a targeted manner. If an immediate relative has digestive tract cancer, then add a gastrointestinal endoscopy. An accurate check is much more useful than a complete set of random checks. As for PET-CT, unless the cancer has been diagnosed and metastasis needs to be checked, there is no need to do a general physical examination. Not only the radiation is large, but small lesions cannot be detected, which is a waste of money.

When you really want to choose a package, it’s easy. Spend 10 minutes in advance to write down a small note about the elderly’s daily problems, medicines taken, and family history. When you go to the physical examination center, ask the health management doctor on duty to help you adjust it. Don’t be embarrassed. Most doctors in public centers will not recommend random items to you. It is much more reliable than choosing from a brochure yourself. Also, don’t think that everything will be fine if you have a physical examination once a year. If the elderly suddenly lose weight quickly recently, always feel pain all over the body, or have changed their bowel habits, don’t wait for the physical examination and go directly to the hospital to see a specialist. The physical examination is just a routine screening and cannot replace seeing a doctor.

To be honest, choosing a physical examination package for the elderly is essentially a matter of prescribing the right medicine. The more expensive the package, the more respectable it is. The most suitable package is the best. Asking the elderly what they usually feel uncomfortable about and paying more attention to their past medical history is more effective than any luxury package.