Do You Know Your Numbers?
Go through this list and fill out all of the information that you know. Whether you have it memorized, or on paper, or go into your patient portal for your provider, fill in as many of these as possible. If any of these are unfamiliar to you, we have a glossary below to help you.
Heart Health
Your LDL:
Your apoB:
Your Lp(a):
Your Blood Pressure:
Metabolic Health
Your Fasting Glucose Level:
Your Hemoglobin A1C Level:
Cancer Prevention Screenings
Date of Colon Cancer Screening:
Date of Lung Cancer Screening:
Date of Skin Cancer Screening:
Date of Prostate Cancer Screening (if applicable):
Date of Breast Cancer Screening (if applicable):
Date of Cervical Cancer Screening (if applicable):
Family History Screenings
Unlike the tests mentioned in the above sections, these two tests are subject whether family history and risk profiles warrant these tests, as they are expensive, not covered by insurance, and not necessary for every patient.
Date of Genetic Testing:
Date of Blood Testing for Cancer:
Why do these numbers matter?
The tests above help give us a good overview of your health at the time of testing. If the numbers look like they might need to be followed to see trends, and follow-up, this is good info. And if the numbers are good, some of these tests can wait before being repeated.
If there are some of these numbers that are missing, and you’re wondering why you haven’t been tested for them, you should have a conversation with your doctor. And if your doctor isn’t able to spend time answering these questions (because, frankly many typical insurance-based primary care offices are under so much pressure by large patient loads) and you want a doctor who has the ability to spend time with patients educating, talking through options, and collaborating with you for your care, maybe DPC (Direct Primary Care) is a better fit for you.
Glossary
LDL: Also known as “bad cholesterol.” A high value increases your chances of developing atherosclerosis, which can cause heart disease and strokes. Lower is better; you should probably aim for less than 130.
apoB: A type of cholesterol, this is a newer test that many doctors don’t order. Your goal should be less
than 90.
Lp(a): A type of cholesterol, this runs in families and is often a culprit when someone has early heart disease. It does not respond to diet and only needs to be checked once. If yours is higher than 75, you should treat cholesterol more aggressively.
Blood Pressure: A very important factor in many types of disease. The “top number” (systolic) should be less than 140 when at rest. The “bottom number” (diastolic) should be less than 90 when at rest. Some patients need lower goals.
Fasting Glucose: Normal is less than 100. If yours is 100-125, you have prediabetes. If yours is 126 or higher, you probably have diabetes.
Hemoglobin A1C: This measures the average blood glucose over time, and helps us sort out when you might be prediabetic. The goal in a non-diabetic is less than 6.
Colon Cancer Screening: Starting at age 40, you should get a test to screen for colon cancer. Average risk people can get Cologuard (an at-home test) or a colonoscopy. Higher risk people need a colonoscopy.
Lung Cancer Screening: If you’re a current or former smoker, you should probably get a low-dose CT scan of your lungs to rule out lung cancer.
Skin Cancer Screening: Check yourself for unusual moles. A primary care doctor can help you with anything that looks suspicious.
Prostate Cancer Screening: If applicable, this is a simple blood test annually to help check for prostate cancer for ages 50+.
Breast Cancer Screening: If applicable, those age 40 and up need breast cancer screening. Mammograms are standard, but the latest data tells us an MRI is also helpful.
Cervical Cancer Screening: If applicable, those who are sexually active should get Pap smears based on their risk factors. For many, a test every few years is plenty.
Cancer Genetic Testing: Some folks with a family history of cancer might benefit from genetic testing that helps us decide if advanced screening for cancer should be done.
Cancer Blood Testing: Some very new tests (Galleri, Cancerguard) screen for many types of cancer with a blood test. These are neat, but expensive and not covered by insurance. Deciding if you should do this is a good conversation to have with your doctor.
