General Preventative Health Recommendations MMC

MMC Health Maintenance Recommendations 2016 Battling the consequences of SIN in this fallen world in Jesus’ name.

Health Maintenance (HM) should be listed on the problem list for EVERY patient visit. Any of the below issues that haven’t been addressed in the past should either be addressed this visit or a plan should be made to address it in the future.

Acronym to use for Health Maintenance = SIN (S.S.S.S.I.N.N) 4 S’s

S – Spiritual – POSSIBLE THINGS TO COVER OVER TIME DEPENDING ON THE PATIENT: Buddhist, Christian? Prayer with patient. Questions? Met with the spiritual impact team? Accepted Christ? Baptism? Home Church/Studying Bible? Being Discipled? Discipling others?

S – Social History/Substance Abuse – SADDDDD - Smoke Exposure (cigarettes, cooking fires), Activity (30 minutes at least 5 times per week), Diet (Portions, Vegtables, etc.), Diabetes Screening (BMI > 22, 40y/o+, FHx), Dental (Refer for screening/problems), Drinks Alcohol, Drug use (illegal).

S – Safety – DASH = Depression (If yes, Suicidal Ideation?), Abuse (Domestic/Child/Sexual), STD (HIV, RPR, Hep B&C, Presumptive Rx of Gonorrhea/Chlamydia if suggestive history, Prevention), Helmet

S – Sanitation 4W’s – Water (Filtered, boiled?), Washing (hands with soap after toilet and before eating AND food preparation – fruits and vegetables before eating), Waste (Toilet?), and Worms (Symptoms and Recent Treatment?).

I – Immunizations – Tetanus x 3 (booster every 10yrs) and Hepatitis B x 3. (Risks and resources for HPV?). If never given to an adult, both vaccines have the same schedule: Dose 1, Dose 2: 1-2 months, Dose 3: 6 months.

N – Neoplasms – Cancer screening: Women - Pelvic Exam, PAP, VIA 25-50y/o+ & Breast Exam 30-70y/o. Consider colonoscopy (Q10 years) and mammography (Q2 years) on patients over 50 if they have resources. HCC screening if liver disease (US/AFP). Remember H. Pylori as a risk factor for Gastric Cancer. Search for malignancy when appropriate based on patient symptoms.

BELOW FOR ALL WOMEN 20-50 Y/O:

N – NEVER FORGET – Preconceptional (Pre-pregnancy) counseling for ALL females 20-50y/o (FAMILY) Folic Acid, Medication Teratogenicity, IgG Rubella, Lab – TSH, Yes to all? Can safely get pregnant and have kids!