– ELIZABETH WEBSTER

Special to the Maine Sunday Telegram

Checkups, when you reach your half-century mark, certainly include a lot of dreaded “C” words. And 50 is the age when they number of tests you should take multiply.

First, there’s the “Big C” — cancer. Patients, turning 50, will have their bodies squished and probed for signs of breast, skin, prostate, cervical and colon cancers. Your doctor will recommend future test frequencies based on your test results.

That’s right, 50 is the magic number for most folks to have their first colonoscopy. The prep for a colonoscopy varies. Dr. Harold Sullivan of Casco Bay Gastroenterology in South Portland has developed a preparation, using Milk of Magnesia and Dulcolax pills.

“Most patients find it very tolerable, and it does not require them to drink a gallon of nasty tasting liquid,” he said. Sullivan’s prep requires a patient to fast for one day before the procedure and to take about four double doses of Milk of Magnesia and four double doses of Dulcolax pills.

Most of his patients opt to be sedated, and once they are, Sullivan starts with a rectal exam and then inserts a long scope into the rectum and advances it by manipulating up around the turns to the end, reaching approximately five feet into the body. “If I find any polyps, I remove them,” Sullivan said, noting that the whole procedure takes about 20 minutes. The patient then recovers in the recovery area for another 45 minutes.

“Having a colonoscopy near age 50 is so important because we want to prevent cancer,” Sullivan said. “Once cancer of the colon is fully developed in the colon wall, it is almost impossible to cure with surgery, chemotherapy, or both. The key to reducing deaths from colon cancer is to take out the polyps when they are benign.”

At age 50, men should have both the prostate specific antigen blood test and a rectal exam to detect any signs of prostate cancer. Women should schedule their yearly mammogram, which can detect early signs of breast cancer, and their annual Pap smear, which can show cervical cancer or conditions that might develop into cervical cancer.

Both sexes should have an annual mole check for the three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma or malignant melanoma.

A CAVITY CHECK

Cavity check: Dr. Denise Theriault at Southern Maine Periodontal Associates in Portland says that oral cancer used to be found in people age 45 and older, “because of smoking and alcohol use, which are co-carcinogens. Now, we are diagnosing oral cancer in younger and older adults, who have never smoked, due to the sexually transmitted human papilloma virus.”

Smoking remains a major risk factor for developing periodontal disease. While there is no cure for periodontal disease, she said that there are treatments to control the disease and prevent tooth loss.

CARDIOVASCULAR

Cardiovascular check: Do you smoke, have high blood pressure, high blood cholesterol, and/or diabetes? Are you overweight/obese, and despise exercise? Then, a heart attack or stroke may be looming.

Dr. Joseph Wight, a cardiologist at Maine Cardiology Associates in South Portland, said “the best case scenario going into your 50s is one where you have maintained a healthy lifestyle with exercise, a normal weight and a balanced diet.”

Otherwise, Wight said that “things tend to start snowballing at age 50.” People who are overweight are more likely get arthritis. “That in turn, makes it harder for them to exercise, and could cause them to become diabetic, which could then lead to sleep apnea,” Wight said.

While it’s hard to change 30 years of habits, Wight said that he’s observed obese patients, who had been taking 30 different medications, drop to zero medications after undergoing gastric bypass surgery and attaining a normal weight and healthy lifestyle.

Readers should know their blood pressure; cholesterol lipid levels, which include total, LDL, HDL and triglycerides; blood sugar levels; and their height, weight and waist circumference. If readers don’t know some of these numbers, this assessment tool will substitute average data for someone their age and gender, making the reader’s risk assessment less accurate

During your age 50 physical, your doctor will check your blood pressure. Hypertension, which hurts your heart, brain, kidneys and eyes, occurs when your blood pressure readings repeatedly go above 140/90. Patients with diabetes should shoot for a reading of 130/80 or lower.

A complete blood chemistry test, taken after an overnight fast, will reveal such important information as:

Your cholesterol profile, which includes your total cholesterol number, which is the sum of your high density lipoprotein (good cholesterol) and low density lipoprotein (or bad cholesterol). The lower the number, the better, and a number below 200 is desired. As for your HDL number, it should be at least 30 percent of your total amount. In men, a HDL number greater than 40 is normal, while an HDL number greater than 50 is normal in women.

Your LDL or bad cholesterol number should be low. Otherwise, your doctor may recommend changes to your diet and/or medication to get your LDL number below 130.

An elevated level of triglycerides — another form of fat in your blood — could indicate an increased risk of heart disease or diabetes. The triglyceride target number should be 150 or less.

A check of your blood glucose level lets you know if you have a normal metabolism (a fasting glucose of less than 100); pre-diabetes (100-125); or diabetes (a level of 126 or greater).

Women, with waist circumferences greater than 35 inches, should request a C-reactive protein test, which measures the amount of inflammation in their bodies. Since arterial inflammation is thought to be involved in heart attacks and strokes, this blood test is considered helpful in diagnosing cardiovascular problems.

A common condition in women in their 50s is an underactive thyroid. The thyroid produces hormones needed for metabolism. Women may want to ask for a thyroid function test.

MUSCLES AND BONES

Chondromalacia (runner’s knee): Dr. James L. Glazer at Coastal Orthopedics & Sports Medicine in Freeport stresses the importance of patients in their 50s staying strong so they can remain “independent and mobile down the road.”

“People in their 40s and 50s have done a good job getting their cardio workouts in, but they also need to keep their muscles strong with weight workouts,” Glazer said.

After a full day of raking, active Weekend Warriors are finding t their bodies aren’t 18 anymore, Glazer said. He sees these patients coming in with back pain and cartilage injuries to their knees and shoulders. He recommends that would-be exercisers “go gradually, be consistent and give more time to warm ups and cool downs.”

He finds that chondroitin sulfate combined with glucosamine does help “keep cartilage from becoming thinner. Any brand will do, but you have to give it about two months to take effect,” Glazer stated.

Charting changes and concerns: For their best head-to-toe physical when they turn 50, patients are encouraged to bring a list of their health concerns with them. It can include everything from hearing and vision problems to acid reflux symptoms to sporadic chest pain to incontinence to needed immunizations to erectile dysfunction. Doctors say that patients, who are forthright with them, will generally enjoy healthier and happier future birthdays.

Elizabeth Webster is a freelance writer who lives in Cape Elizabeth.