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Questions?
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Q. Why should I have a comprehensive health exam?
A. There is no question that those of us who eat well, exercise regularly, practice good safety, and avoid self-destructive habits are most likely to live long, healthy lives. Yet illness can strike even the healthiest among us. Tragically for 150,000 Americans each year the first sign of heart disease is sudden death. We now know that it's possible to easily detect early signs of atherosclerosis in the arteries that supply the heart muscle, and most importantly, prevent a potentially fatal heart attack. The power of prevention also applies to cancer. Colon cancer, lung cancer, breast cancer, skin cancer, prostate cancer, kidney cancer, lymphatic cancer, and many others can be detected at a stage when cure is possible. Similarly, osteoporosis can be detected and serious fractures prevented. The potentially tragic consequences of diabetes and high blood pressure can be avoided. Waiting for symptoms to develop or having a cursory check-up is not enough.
By using the most contemporary laboratory testing, appropriately selected imaging, and virtually unlimited time from a trusted physician, you will have the best health evaluation currently available. Our goals for the are simple-identify health risks and modify them; diagnose disease at a stage when cure is possible; promote healthy habits; and provide peace of mind.
A. Using the 64-slice GE scanner, it is now possible in only a few minutes to examine your coronary arteries, major blood vessels, lungs, and the solid organs of your abdomen. Equally important, our radiologists work collaboratively with our clinicians to provide the best, most accurate interpretation of your CT scan.
Q. What if my scan finds unimportant findings known as false-positives?
A. False-positives are radiographic findings that turn out to have no medical significance; for example, a small nodule discovered in one of the lungs. In most cases experienced radiologists can confidently tell innocent nodules from potential worrisome ones. In a few cases the radiologist will recommend that a limited scan of a nodule be repeated in a few months to assure that it has not changed. Occasionally, a different type of scan-MRI or PET scan-may be needed to provide additional information. For the vast majority of patients no follow-up will be necessary. False-positives can occur with any medical test-even an ordinary chest x-ray.
Everyone feels some degree of apprehension about finding something wrong. That’s normal. You will most likely be comforted by the outcome. If a problem or risk is identified, that’s an opportunity to do something about it at an early stage.
Q. What about radiation exposure?
A. We know that people are concerned about radiation exposure. So are we. We use the least amount of radiation necessary to obtain clear images of your heart, blood vessels, lungs, and abdomen. For periodic follow-up examinations, we use ultrasound to evaluate your abdominal aorta and internal organs. Ultrasound is painless and does not expose you to any radiation.
Q. Will I feel confined or claustrophobic?
A. No. The scanner is wide open and, for most of the procedure, your head will be outside of the scanner. It is not at all like an MRI.
Q. How will I understand my results?
A. At least as important as the results is understanding them. Simply sliding through a scanner and being handed a report is not good medicine and may lead to unnecessary alarm.
Your laboratory tests will be reviewed item by item. Importantly, your results will be interpreted in the context of your overall health, risks, medications, etc.
To fully understand your scans it will be necessary to show you various anatomic models and pictures. This will not be as daunting as you might think. Important organs will be clearly pointed out as you go on a virtual tour of your body. Everyone who goes through the program is amazed at how clearly they're able to see inside their body. It is our firm belief that good health begins with knowledge.
Q. If my body scan is entirely normal, does that mean I’m totally free of disease?
A. Not all diseases can be detected on a scan. Many important problems are discovered from blood tests, e.g. diabetes, anemia, thyroid problems, certain types of blood cancer, etc., and by careful physical exam. Unfortunately, no exam - no matter how complete - can detect everything. Within the limits of the tests, you will have one of the most comprehensive health exams available today.
Q. What is the importance of a heart scan?
A. The heart scan looks for signs of calcified plaque in the coronary arteries that feed the heart muscle. Plaque in the walls of the coronary arteries can build up and harden (calcify) long before the lumen (channel) becomes blocked. Even the most sophisticated treadmill test will not become positive (abnormal) until 70% of a coronary artery is blocked. Waiting to develop chest pain or for a treadmill to become positive may be too late. Finding evidence of atherosclerosis early is the first critical step towards prevention of a heart attack or stroke.
You should know, however, that most men over the age of 40 and women over the age of 50 will have some degree of calcification. So, do not be alarmed if your score is not zero. With appropriate changes in diet, exercise and medications, we now know that the process of atherosclerosis can be stabilized or even reversed.
Q. I have a normal cholesterol level. Is the heart scan still important for me?
A. Having normal cholesterol puts you at a lower risk than average for heart disease. However, most people who suffer a heart attack actually have "normal" cholesterol. Some people with high calcium scores on their heart scan need to achieve a very low cholesterol level to reduce their risk of heart attack. The best way to know if you need aggressive cholesterol management is to know your coronary calcium score.
Q. Is a heart scan important for women, too?
A. Absolutely! Cardiovascular disease, including stroke, claims more women’s lives than the next seven causes of death combined - nearly 500,000 a year-almost twice as many as all forms of cancer. One in 2.5 women will die of heart disease or stroke, compared with one in 30 from breast cancer. Knowing your risks and doing something about them is every bit as important for women as it is for men. Prevention of heart disease in women has been neglected far too long!
Q. Will the heart scan tell me how much blockage there is in my coronary arteries?
A. Although it is possible for us to make some generalizations about the degree of coronary narrowing that likely exists, it is not the primary purpose of this test. The primary purpose of the test is to detect disease before there is much narrowing. Doctors now know that more than half of all heart attacks occur at sites of less than 50% narrowing. No other noninvasive test in cardiology can detect this type of early disease.
Q. How will I know if I'm at risk for a stroke?
A. Oxygen-rich blood is supplied to your brain via the carotid arteries. Because the carotids run so close to the surface of the neck, they can be imaged and measured. Using highly specialized ultrasound equipment and software we will measure the thickness of the inner walls of your carotid arteries. Thickening of the wall of an artery is one of the very earliest steps in the process of atherosclerosis. Even before plaque in the arterial wall hardens or calcifies the inner layer of the carotids will thicken indicating that plaque is beginning to form. At this early stage of atherosclerosis we have the best opportunity to stop, or even reverse, the build up of fatty plaque. Year-to-year comparison of carotid artery thickness is one of the safest and best ways to assure you that your arteries remain healthy and free of plaque build-up.
Q. What is an aneurysm and can one be discovered before it ruptures?
A. An aneurysm is a “ballooning” of a portion of an artery. Aneurysms can occur in virtually any artery in the body. They occur in the aorta in approximately 7% of men over the age of 60. The body scan reveals the entire aorta from where it leaves the heart to where it divides in the legs. If discovered early, a significantly large aneurysm can be surgically repaired and rupture prevented.
Aneurysms can also occur in the arteries of the brain. They are less common. Discovering them requires injecting dye into a vein before scanning. For most people this is not necessary. Those with a history of family members who have died from a ruptured cerebral aneurysm may be appropriate for a vascular brain scan.
Q. Why should I have a colonoscopy?
A. Colorectal cancer is the second leading cause of cancer deaths. Colorectal cancer is over 90% curable when detected early. Men and women are affected equally. Simply put, screening colonoscopy saves lives! Almost everyone older than age 50 should have one. We can help you decide which type of colonoscopy is best for you and refer you to an expert to perform the test.
Q. What is the difference between a conventional, optical colonoscopy and
the newer virtual colonoscopy?
A. In a conventional colonoscopy, the doctor inserts a colonoscope – a long, flexible, lighted tube – into the patient’s rectum and slowly guides it up through the colon. Pain medication and a mild sedative help the patient stay relaxed and comfortable during the 30- to 60-minute procedure. A tiny camera in the scope transmits an image of the lining of the colon, so the doctor can examine it on a video monitor. If an abnormality is detected, the doctor can remove it or take tissue samples using tiny instruments passed through the scope.
Virtual colonoscopy (VC) uses x rays and computers to produce two- and three-dimensional images of the colon (large intestine) from the lowest part, the rectum, all the way to the lower end of the small intestine and display them on a screen. VC is more comfortable than conventional colonoscopy for many people because it does not use a colonoscope. As a result, no sedation is needed and you can return to your usual activities or go home after the procedure without the aid of another person. It is especially valuable in “failed colonoscopy,” where the scope could not reach the entire length of the colon.
Q. What kind of report will I receive?
A. A board-certified radiologist will review your scans. The radiologist will meticulously examine each organ included in the scan and record those comments in a formal report which will be given to you at the end of your exam. You will also be given a CD of your scan for your own review. The CD does not require any special software to be seen by you or another physician. You will also be given a detailed copy of your complete lab report, electrocardiogram, audiometry, and pulmonary function tests. We will copy your electronic medical record to a keychain-size USB flash memory drive so that you can have access to your medical record anytime, anywhere. We believe it is important for you to keep your own health record in addition to the records your physician keeps on your behalf.
Q. How often should I have such a comprehensive health exam?
A. The appropriate frequency for a comprehensive health exam will depend on your age, general health, and any specific problems that may have been discovered. For most people a repeat CT scan should not be done for at least 4-5 years.
Q. Will a report be sent to my primary care physician?
A. With your permission, a complete report will be sent to your primary care physician. This is something we urge you to do so that your physician will have all the information that has been gained from your exam. Ongoing management of any problems and risk factors is the key to prevention of serious disease.
Q. Will comprehensive exam be covered by my health insurance?
A. Unfortunately the exam is not a covered benefit of Medicare, Medicaid, or most insurance companies. Full payment is appreciated at the time of your exam. We accept MasterCard, Visa, American Express, or personal check.
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