Dr. Steven Shechtman discusses staying healthy over 60.
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Staying Healthy Over 60
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Learn more about Steven J. Shechtman, MD
Steven Shechtman, MD
Dr. Steven Shechtman is board certified in internal medicine and serves the Wesley Chapel community for BayCare Medical Group. Dr. Shechtman focuses on the long-term, comprehensive and complex illnesses of adolescents, adults and the elderly. He is trained in the diagnosis and treatment of cancer, infections and diseases affecting the endocrine, neurologic, heart, blood, kidneys, joints and digestive, respiratory and vascular systems. Dr. Shechtman understands the essentials of primary care internal medicine and incorporates the understanding of disease prevention and wellness. He strives to educate his patients on their conditions and become active participants in their care decisions. Dr. Shechtman completed an undergraduate degree in psychology from the University of Florida in Gainesville, Florida and then earned his Doctor of Medicine from St. George’s University School of Medicine in Great River, New York. He then continued his medical education by completing an internal medicine residency at West Penn and Allegheny Hospitals in Pittsburgh, Pennsylvania. Dr. Shechtman is thorough and comprehensive in his patient care and values his dedication toward his patients and their well-being.Learn more about Steven J. Shechtman, MD
Transcription:
Introduction: This is BayCare HealthChat, another podcast from BayCare Health System. Here's Melanie Cole.
Melanie Cole: When you're young, you may think you have your whole life to get healthy and make better choices about eating and exercising. While changing your lifestyle to a healthier one can be challenging at any age. It does seem to be a little more difficult as you get older. Welcome to BayCare HealthChat. I'm Melanie Cole, and today we're discussing staying healthy over 60. Joining me is Dr. Steven Shechtman, he's Board Certified in Internal Medicine at BayCare. Dr. Shechtman it's a pleasure to have you join us today. As annual wellness exams are really an important part when we're in our sixties. What are the most important components of that type of a physical, why is it important to know our numbers?
Dr. Shechtman: Yeah, so annual wellness is very important reason being is that we screen for a lot of conditions that can be basically if they're identified early on, complications can be prevented. So basically annual wellness consists of lab work as well as, a physical exam and discussion of various topics, which I know we're going to get into more. But getting an understanding of a person's overall health is very important in order to identify and treat these conditions early so that they don't progress. And that complications don't occur the longer these conditions persist without treatment, the more complications that can occur.
Host: What a great point. So Doctor, sometimes we're hesitant to voice our concerns to our physicians, but we really need to listen to our bodies. And at that age we start to feel, Oh, well, if I call my Doctor, I'm going to sound like a hypochondriac. What would you like listeners to know about the importance of voicing anything, whether it's chest pain or a pain in the elbow, whatever it is to be upfront and honest with our physicians.
Dr. Shechtman: It's very important that the patients are, like you said, up front and honest, because it's really the way that the clinician is gathering information. We base a lot of our testing and as well as our exam and our questioning based on what the patients tell us, a lot of things are not screened for. And in fact, we only test for if people have active complaints, which we call this more testing diagnostically. And if the patient does not report these signs and symptoms that they experienced, then we really won't be able to really delve into this problem. And it might be much more serious than the patient believes, instead of putting it off, it could be a sign of something that, that can be uncovered early on.
Host: Well, it's so important to know that. So let's get into some of these Doctor first, let's start about vaccinations. We think of vaccinations as things that kids get, but adults need them too. What vaccinations do you cover with us?
Dr. Shechtman: Yeah. So there's different vaccinations, like you said, depending on the situation, certain vaccinations can be given at different times. So, basically then there's pneumonia vaccines, which are given most of the time we give them at the age of 65, the first one would be at 65 and it's Pneumovax and Prevnar. And the second one would be a year later, 66, but certain conditions, we actually give one of those pneumonia vaccines, either Pneumovax or Prevnar prior to the age of 65. And that would be if a person has certain conditions such as alcoholism, diabetes, and immuno deficiencies and or lung disease or heart disease. So, and there's also other vaccinations such as tetanus, which we will give a Tdap Booster every 10 years and essentially the shingles vaccine, which is now there's a new shingles vaccine called Shingrix. And that should be given in people over 50 years old. And basically it's a shared series of two shots and it's very protective against shingles for some one that's had chicken pox in their youth.
Host: So Doctor, when we're in our sixties, we're used to the blood work that you do taking our blood pressure, cholesterol, all of these things that you do in blood work. Besides the blood work, what are some other important screenings to consider, speak about bone health or colonoscopies, mammograms, and even the importance of you discussing with your patients, sleep, mental health, diet and exercise, all of those other things besides the standard blood work and exams.
Dr. Shechtman: Yeah. So the screening like you mentioned is very important besides just the lab work. So colonoscopies is screening for colon cancer, it's the gold standard. And that is really the ideal test. Some people that refuse colonoscopy that don't want a colonoscopy. We, in certain situations we can do what's called Cologuard, which is a special stool test, but it's not as accurate, that will identify polyps that could certainly become cancerous. And you can remove the polyps via the colonoscopy. Other screening for females involve mammograms, and that would screen for breast cancer and also the pap smears, which would screen for cervical cancer as well as bone density testing. Typically we start bone density testing at the age of 65. Otherwise we can, it's started younger in females that have an increased risk, which would include certain risk factors, such as smoking and alcohol use and family history, but certainly depression screening as well. It's very important to maintain good mental health, as that influences physical health. Screening eyes, dilated eye exam, is important, so we recommend that depending on the age and depending on the person's symptoms, we recommend that every two to four years. Hearing exams as well, we do a screening on physical exam test hearing and certainly skin exams, people with exposure to sun and people have family history of skin cancer. And that can be very detrimental if it's not taken care of.
Host: So Doctor, we mentioned sleep before, and this is something that alludes many of us and it's been linked to a lack of sleep, has been linked to diabetes, obesity. All of these things are mental health, speak about the importance of sleep and who we should consult if we are having trouble sleeping.
Dr. Shechtman: So as you mentioned, sleep is very important. And basically we see a lot of different problems for sleep in our clinic, including sleep apnea, insomnia, parasomnias. And basically I would recommend consulting with an internal primary care physician initially to see, and to describe exactly the situation and if you're having trouble falling asleep, staying asleep. And certainly there could be a lot of different causes to this. And in this can certainly be assessed by the primary care physician based on the patient's description and their medical history.
Host: So speak about how you counsel your patients on diet and exercise. As we said, obesity is linked to so many diseases, you know, in this day and age. And including diet and exercise with maybe alcohol or, you know, self-injurious habits and addictions and overeating and eating junk and sedentary lifestyle, kind of put that all into perspective for us on what you tell your patients every day about the importance of trying to maintain these healthy lifestyle behaviors.
Dr. Shechtman: Sure. Diet and exercise is, like you mentioned, very important. There's many different types of diets, and certainly diet is based upon different factors, such as a person's dietary preferences and their goals based on the conditions that they have. Certainly there's general rules such as eating healthy fats and, you know, a good general rule for that is to try to avoid solid fats that are solid at room temperature, and to try to stick with the plant based oils, such as the polyunsaturated and monounsaturated fats, which are much healthier to a person's lipid profile, as well as avoiding foods that are refined sugars and to trying to eat sugars that are lower on the glycemic index. So basically though a few, a few good diets that people, as far as dietary regimens that people can use are something like the Mediterranean diet and Dash diet, you know.
Otherwise basically in regards to exercise, that's also, like you said, very important. We want people to get, at least we recommend at least 150 minutes of moderate intense exercise per week. And that involves mainly three components of exercise, which is aerobic, which strengthens your, your lungs and your heart. Resistance, which is a muscle strengthening and stretching. And exercise is very important as well, besides mood and energy. And like you said, the glucose control as well as bone strength and weight control, as well as blood pressure reduction. In regards to interest behaviors such as alcohol and smoking. It's important for people to discuss this with their physician and the physician will need to really elucidate the patient's patterns of thinking and their triggers and their goals. And basically, you know, depending on the patient, the plan would obviously, can vary a lot in order to help people to minimize these self-interest behaviors, which are dangerous to the patient's health in many different ways.
Host: It's great information and so important for us to hear. So wrap it up for us, Dr. Shechtman, with what you would like listeners to know about staying healthy over 60, the importance of vaccinations and annual well visits and voicing your concerns with your physician, and being upfront and honest about all of your concerns so that we can be our own best health advocate.
Dr. Shechtman: Yeah. You know, the relationship between patient and a physician is a team and the patients need to be able to be comfortable and be able to discuss with their physician, their signs and symptoms, as well as being comfortable discussing their goals with the physician so that they can achieve their health goals and establish a relationship for if they have any health issues as well. So that it can be taken care of in an expedient manner and the patient can maintain good health.
Host: Well, thank you so much, Doctor, for joining us today and reiterating and reinforcing the importance of all of these things. So we can stay healthy over 60. That concludes this episode of BayCare HealthChat. Please visit our website at baycare.org for more information, and to get connected with one of our providers. Please also remember to subscribe, rate, and review this podcast and all the other BayCare podcasts. I'm Melanie Cole.
Introduction: This is BayCare HealthChat, another podcast from BayCare Health System. Here's Melanie Cole.
Melanie Cole: When you're young, you may think you have your whole life to get healthy and make better choices about eating and exercising. While changing your lifestyle to a healthier one can be challenging at any age. It does seem to be a little more difficult as you get older. Welcome to BayCare HealthChat. I'm Melanie Cole, and today we're discussing staying healthy over 60. Joining me is Dr. Steven Shechtman, he's Board Certified in Internal Medicine at BayCare. Dr. Shechtman it's a pleasure to have you join us today. As annual wellness exams are really an important part when we're in our sixties. What are the most important components of that type of a physical, why is it important to know our numbers?
Dr. Shechtman: Yeah, so annual wellness is very important reason being is that we screen for a lot of conditions that can be basically if they're identified early on, complications can be prevented. So basically annual wellness consists of lab work as well as, a physical exam and discussion of various topics, which I know we're going to get into more. But getting an understanding of a person's overall health is very important in order to identify and treat these conditions early so that they don't progress. And that complications don't occur the longer these conditions persist without treatment, the more complications that can occur.
Host: What a great point. So Doctor, sometimes we're hesitant to voice our concerns to our physicians, but we really need to listen to our bodies. And at that age we start to feel, Oh, well, if I call my Doctor, I'm going to sound like a hypochondriac. What would you like listeners to know about the importance of voicing anything, whether it's chest pain or a pain in the elbow, whatever it is to be upfront and honest with our physicians.
Dr. Shechtman: It's very important that the patients are, like you said, up front and honest, because it's really the way that the clinician is gathering information. We base a lot of our testing and as well as our exam and our questioning based on what the patients tell us, a lot of things are not screened for. And in fact, we only test for if people have active complaints, which we call this more testing diagnostically. And if the patient does not report these signs and symptoms that they experienced, then we really won't be able to really delve into this problem. And it might be much more serious than the patient believes, instead of putting it off, it could be a sign of something that, that can be uncovered early on.
Host: Well, it's so important to know that. So let's get into some of these Doctor first, let's start about vaccinations. We think of vaccinations as things that kids get, but adults need them too. What vaccinations do you cover with us?
Dr. Shechtman: Yeah. So there's different vaccinations, like you said, depending on the situation, certain vaccinations can be given at different times. So, basically then there's pneumonia vaccines, which are given most of the time we give them at the age of 65, the first one would be at 65 and it's Pneumovax and Prevnar. And the second one would be a year later, 66, but certain conditions, we actually give one of those pneumonia vaccines, either Pneumovax or Prevnar prior to the age of 65. And that would be if a person has certain conditions such as alcoholism, diabetes, and immuno deficiencies and or lung disease or heart disease. So, and there's also other vaccinations such as tetanus, which we will give a Tdap Booster every 10 years and essentially the shingles vaccine, which is now there's a new shingles vaccine called Shingrix. And that should be given in people over 50 years old. And basically it's a shared series of two shots and it's very protective against shingles for some one that's had chicken pox in their youth.
Host: So Doctor, when we're in our sixties, we're used to the blood work that you do taking our blood pressure, cholesterol, all of these things that you do in blood work. Besides the blood work, what are some other important screenings to consider, speak about bone health or colonoscopies, mammograms, and even the importance of you discussing with your patients, sleep, mental health, diet and exercise, all of those other things besides the standard blood work and exams.
Dr. Shechtman: Yeah. So the screening like you mentioned is very important besides just the lab work. So colonoscopies is screening for colon cancer, it's the gold standard. And that is really the ideal test. Some people that refuse colonoscopy that don't want a colonoscopy. We, in certain situations we can do what's called Cologuard, which is a special stool test, but it's not as accurate, that will identify polyps that could certainly become cancerous. And you can remove the polyps via the colonoscopy. Other screening for females involve mammograms, and that would screen for breast cancer and also the pap smears, which would screen for cervical cancer as well as bone density testing. Typically we start bone density testing at the age of 65. Otherwise we can, it's started younger in females that have an increased risk, which would include certain risk factors, such as smoking and alcohol use and family history, but certainly depression screening as well. It's very important to maintain good mental health, as that influences physical health. Screening eyes, dilated eye exam, is important, so we recommend that depending on the age and depending on the person's symptoms, we recommend that every two to four years. Hearing exams as well, we do a screening on physical exam test hearing and certainly skin exams, people with exposure to sun and people have family history of skin cancer. And that can be very detrimental if it's not taken care of.
Host: So Doctor, we mentioned sleep before, and this is something that alludes many of us and it's been linked to a lack of sleep, has been linked to diabetes, obesity. All of these things are mental health, speak about the importance of sleep and who we should consult if we are having trouble sleeping.
Dr. Shechtman: So as you mentioned, sleep is very important. And basically we see a lot of different problems for sleep in our clinic, including sleep apnea, insomnia, parasomnias. And basically I would recommend consulting with an internal primary care physician initially to see, and to describe exactly the situation and if you're having trouble falling asleep, staying asleep. And certainly there could be a lot of different causes to this. And in this can certainly be assessed by the primary care physician based on the patient's description and their medical history.
Host: So speak about how you counsel your patients on diet and exercise. As we said, obesity is linked to so many diseases, you know, in this day and age. And including diet and exercise with maybe alcohol or, you know, self-injurious habits and addictions and overeating and eating junk and sedentary lifestyle, kind of put that all into perspective for us on what you tell your patients every day about the importance of trying to maintain these healthy lifestyle behaviors.
Dr. Shechtman: Sure. Diet and exercise is, like you mentioned, very important. There's many different types of diets, and certainly diet is based upon different factors, such as a person's dietary preferences and their goals based on the conditions that they have. Certainly there's general rules such as eating healthy fats and, you know, a good general rule for that is to try to avoid solid fats that are solid at room temperature, and to try to stick with the plant based oils, such as the polyunsaturated and monounsaturated fats, which are much healthier to a person's lipid profile, as well as avoiding foods that are refined sugars and to trying to eat sugars that are lower on the glycemic index. So basically though a few, a few good diets that people, as far as dietary regimens that people can use are something like the Mediterranean diet and Dash diet, you know.
Otherwise basically in regards to exercise, that's also, like you said, very important. We want people to get, at least we recommend at least 150 minutes of moderate intense exercise per week. And that involves mainly three components of exercise, which is aerobic, which strengthens your, your lungs and your heart. Resistance, which is a muscle strengthening and stretching. And exercise is very important as well, besides mood and energy. And like you said, the glucose control as well as bone strength and weight control, as well as blood pressure reduction. In regards to interest behaviors such as alcohol and smoking. It's important for people to discuss this with their physician and the physician will need to really elucidate the patient's patterns of thinking and their triggers and their goals. And basically, you know, depending on the patient, the plan would obviously, can vary a lot in order to help people to minimize these self-interest behaviors, which are dangerous to the patient's health in many different ways.
Host: It's great information and so important for us to hear. So wrap it up for us, Dr. Shechtman, with what you would like listeners to know about staying healthy over 60, the importance of vaccinations and annual well visits and voicing your concerns with your physician, and being upfront and honest about all of your concerns so that we can be our own best health advocate.
Dr. Shechtman: Yeah. You know, the relationship between patient and a physician is a team and the patients need to be able to be comfortable and be able to discuss with their physician, their signs and symptoms, as well as being comfortable discussing their goals with the physician so that they can achieve their health goals and establish a relationship for if they have any health issues as well. So that it can be taken care of in an expedient manner and the patient can maintain good health.
Host: Well, thank you so much, Doctor, for joining us today and reiterating and reinforcing the importance of all of these things. So we can stay healthy over 60. That concludes this episode of BayCare HealthChat. Please visit our website at baycare.org for more information, and to get connected with one of our providers. Please also remember to subscribe, rate, and review this podcast and all the other BayCare podcasts. I'm Melanie Cole.