You can enjoy the later years of your life.  They can be a time of great change.  Retirement may be in your future.  New challenges may be seen as you explore new hobbies and interests.  You are making decisions concerning your life and future. It is important that you make wise choices regarding your lifestyle.  Your work and roles in the home and community may change.  Relationships develop and change over the course of time.  Communicate with your partner your goals and expectations of each other.  You may have grandchildren.  Stress and depression can affect your physical and mental health, relationships and your self-image.  You may notice physical changes such as graying of the hair, vision changes including a loss of peripheral vision; decreased hearing, sense of smell and taste; minor injuries taking longer to heal, decreased muscle strength, slower reactions (reflexes) and decreased coordination, constipation, minor difficulties with urination, memory changes, and skin changes such as wrinkles.  These are all normal changes that occur with aging.


Your health is important. A physical exam and health history are important to detect health problems early. During the exam, nutrition, exercise, vaccines and boosters, important tests, and possible risk factors to diseases are discussed. Your cholesterol level and blood pressure are checked. Proper nutrition is important. Eat a low fat diet. Keep added salt and sugar to a minimum. Avoid junk food and limit carbohydrate snacks. Participate in physical activity on a regular basis. An exercise program of 30 minutes a day, three days a week is a great way to keep fit and toned and relieve stress.  Walking is a great way to exercise.  Choose something you enjoy doing and stick with it. Vary your exercise program to keep you motivated.  Poor diet, too much fat and cholesterol, and lack of exercise can increase your risk for heart disease and other diseases. Obesity can lead to health problems such as diabetes, high blood pressure, arthritis and heart disease.  High blood pressure that is untreated can lead to heart disease and stroke.  Get plenty of calcium from low fat milk, cheeses, yogurt or dietary supplements to prevent osteoporosis (thinning of the bones).  Make sure you get adequate sleep.  You may be fatigued more often.  If you are experiencing any problems with your sleep, talk to your doctor.  You may need certain booster shots to keep your immunizations up to date. A tetanus vaccine is recommended every ten years.  Influenza and pneumonia vaccines may be given.  A satisfying sex life can be enjoyed.  If you have concerns regarding your ability or drive, talk to your doctor.  A PAP smear is a part of your health exam and should be done every 3 to 5 years up to the age of 65.  Many experts now question the necessity of a PAP smear after the age of 65 and in women who have had surgery to remove the uterus (hysterectomy).  Monthly self-breast exams are potentially still helpful to diagnose breast cancer early.  However, regular mammograms are the best way to improve your overall chances of a cure.  Colon cancer can be detected sooner and maybe even prevented by regular exams of the colon called colonoscopies.  Everyone should have one after the age of 50 and at least every 10 years thereafter. Schedule an appointment with an optometrist to check your vision, and to check for glaucoma.  Smoking, alcohol, and illegal drug use increase your risk for several diseases. Stop smoking if you smoke. It can cause many diseases affecting the heart and lungs, increase the frequency of colds and respiratory infections. Alcohol causes damage to the brain and liver.  Even infrequent drinking can be disruptive to your family life and work.  Schedule a dentist appointment at least yearly for a regular check up.  Use sunscreen of 15 SPF or higher to prevent skin damage and wear a broad brimmed hat while in the sun.  Avoiding sun exposure and sunburns can help prevent skin cancer and wrinkles later on.  Additional exams and tests depend on your personal risks.  Death and dying issues may surface as friends and loved ones pass away.  The loss can be very painful to deal with.  Talk to your doctor if you are having a difficult time coping with a loss.  It is important to take an active role in your health care.


Injury and Accident Prevention – Wear protective gear for work or hobbies that use machinery or that can cause injury.  Falling is a common problem as you get older.  Take precautions against potential fall injuries. One of the best methods for preventing falls is to maintain muscle strength through regular exercise. Learn firearm safety even if you do not keep guns in your own home. Learn the appropriate and safe way to use power tools.  Install smoke detectors in your home if you do not have them already; change the batteries every six months (when daylight savings time starts and ends).  Drive responsibly, do not speed, and do not drive when angry or under the influence of any substance.  Always wear your seatbelt while in the car even if you have airbags. Never drive a car, motorcycle, or boat if you have been drinking. Choose a designated driver or call a taxi instead. Injuries can result to your wrist, back, and neck from sitting at a desk or using a computer for long periods of time. Take breaks to minimize injury.


Contact your doctor if a severe reaction develops to any immunizations or boosters given, chest pain, shortness of breath, change in bowel or bladder habits, blood in your stool, unusual bleeding or discharge, sore throat that does not heal, unusual skin spots, changes in warts or moles, cough or hoarseness, changes in your weight with no change in diet, difficulties with menopause, or if you experience depression, suicidal thoughts, addictions, or have any other health concern.



Dr. Purl will provide you with your own individual screening schedule of exams and tests that are government recommended for your age and medical condition:


Annual physical exam:

Weight reduction follow up:

Cholesterol screening: normal value every 5 years:

Cholesterol screening: abnormal on diet: every year:

Cholesterol screening: on medications: every 6 months:

Diabetes screening: annual if HTN, BMI > 30, high chol, prior abnl:

Diabetes screening: annual if 2 or more: BMI 25-29, FHX DM, Age 65 +, had baby >9#:

Glaucoma screening: annual if DM, FHx glaucom, Black >50, Hispanic >65

Mammogram: annual after 40:

Pap and Pelvic exam: every 3 years:

Colonoscopy: every 10 years for normal risk factors:

Colonoscopy: every 5 years for high risk:

Tetanus shot: every 10 years:

Flu shot: every year:

Pneumococcal pneumonia shot: once after age 65

Pneumococcal pneumonia shot booster every 5 years if high risk:

Screening for abdominal aortic aneurism: once if male 65 that has smoked 100 cigarettes

Bone density test: every two years:

Smoking cessation counselling: