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No. 3

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by Dr. Rodger Sayre
- disclaimer -
“When is an Ounce Worth More Than a Pound?”

There is nowhere sacred in my household! Recently, as I stood in the bathroom brushing my teeth, one of my children charged around the corner unannounced and wrapped her arms around my waist. Teary-eyed she gazed up at me and said, “Daddy, I don’t want you to die.”

HSLDA/Mark Thoburn

I was both puzzled and surprised by the sudden emotion. I asked, “What makes you think Daddy is going to die?”

“Well…you’re old, aren’t you?” she replied.

I stared intently at my own reflection in the mirror. “OK,” I thought, “I am getting gray, and my skin lacks the turgor it once had, but did she have to be so blunt?” My gaze drifted downward to a precious child, still clutching my khakis. I swept aside her hair from her face, and gave a reassuring hug. “I don’t think I’ll die anytime soon,” I said.

I had lots more to say, but glancing at my watch I realized I was late for work—again. I would need to take up discussions of death, eternity, and the lilies of the field at a later time. For now, this interchange had been a poignant reminder of both my mortality and the awesome responsibility of being a father.

I believe that as parents we have an obligation to God and our families to take good care of our bodies. The old adage “an ounce of prevention is worth a pound of cure” is perhaps more applicable to the area of health care than any other realm of life. In fact, objective evidence is building that prevention and/or early detection of disease saves both lives and money. Hence the big push lately for people to visit their physicians for checkups on a regular basis.

In our last article, for purposes of simplicity, we divided preventative care of adults into FOUR MAIN CATEGORIES: (1) cancer screening, (2) cardiovascular screening, (3) metabolic screening (for conditions such as diabetes), and (4) infectious disease prevention. While the first article focused on cancer screening, we will now turn our attention to the last three categories.


Category 2: Cardiovascular screening
Cardiovascular screening is mainly accomplished by assessing a person’s risk factors. The five main risk factors for heart disease include lipid abnormalities (most commonly an elevation in the LDL cholesterol, or the so-called “bad cholesterol”), smoking, a positive family history, high blood pressure, and diabetes. In my years of practice, I have seen a striking correlation between increased LDL cholesterol and heart attacks. Current recommendations are to screen for lipid abnormalities every five years, starting at age 35 for men and age 45 for women. Obviously, if the levels are determined to be abnormal, more frequent monitoring would be required. Checking for high blood pressure, asking about smoking, and screening for diabetes should be done yearly at a general physical exam. Although you really can’t do much about family history, the other four risk factors are treatable, and your doctor can help devise a plan for reducing your risks.

Category 3: Metabolic screening
Metabolic problems for which I regularly screen include diabetes, obesity, and osteoporosis. Diabetes and obesity are rampant in our society, and are either directly or indirectly responsible for a great deal of the morbidity and mortality in a medical practice. Illnesses such as coronary artery disease, hypertension, kidney failure, blindness, and foot and leg ulcers are the direct result of these two conditions. A simple blood test and an accurate scale are all that are needed to identify diabetes and obesity. Osteoporosis is a thinning of the bone, and can result in fractures of the spine, hip, and other bones from even minor trauma. Osteoporosis is usually identified by a special x-ray called a DEXA scan. Treatment options are available to minimize the impact of all of these conditions on long-term health.

Category 4: Infectious disease prevention
Last on our checklist for maintaining good health as an adult are immunizations against infectious diseases. It is recommended that adults stay current for tetanus and pertussis prophylaxis, and consider pneumonia and flu vaccinations as age and other health issues may indicate. A discussion with your trusted health care provider will help you sort out what immunizations are indicated in your particular situation.

Of course, understood in this discussion of adult preventative care is the importance of a good diet, adequate sleep, and regular aerobic exercise. These issues have been addressed in earlier columns.

I try to practice what I preach, including exercising regularly. When I returned from jogging recently, Daniel (age 4) asked me, “Are you going to push hiccups now?”

“What?” I managed to insert between panting respirations.

“Are you going to push hiccups?”

I bent over, supporting my upper body with my hands on my knees. I searched his face, sweat dripping from my chin. Gradually the light began to dawn in my hypoxic brain. “Do you mean, am I going to do push-ups?”


I was unable to do my push-ups that day, because every time I started I began to laugh. Have you ever tried to do push-ups while laughing?

And although everyone in our household takes physical fitness seriously, most of us are struggling with our “body mass index.” And so the following verbatim interchange occurred between Daniel and one of his sisters (name withheld) as she brushed her hair before church:

Daniel: You look like Florence Nightingale’s mom…except fat.

Sister: Who’s fat, Florence Nightingale’s mom or me?

Daniel: Well…you…I guess…but Rachel’s not fat. No, she is as skinny as me…I mean, as skinny as I.

Sister: But why is being skinny good?

Daniel: Well…I like cowboy beans.

Daniel is destined to be president.

About the author

Rodger Sayre, MD, FAAFP, has been an HSLDA board member since 1997. He and his wife, Mary, homeschool their 11 children. Dr. Sayre received his medical degree from Thomas Jefferson University, is a Diplomat of the American Board of Family Medicine, and is a Geisinger Medical Group associate with a busy practice in Tunkhannock, Pennsylvania.