What are these (included in healthy screening)?

[sunnysandiegan]

My DD earned a free summer camp through Girl Scouts and GS requires a health exam. I called her insurance and they have a "Healthy Check" service for $25 that covers everything GS requires and then some. What are the following services in a regular doctor's office? How are they performed? (Particularly the purple ones.) Would you accept all or refuse some for your children? Why?

$25 Basic Screening (for children ages 7-17 and adults 18 and over) includes

• blood pressure
• height and weight
• pulse and resting heart rate
• listen to heart and lungs with a stethoscope
• check lymph nodes, thyroid and abdomen for abnormalities
• observe ears and oral cavity
• body mass index (BMI)
• skin cancer evaluation and education
• Tetanus and Diphtheria booster
• Tetanus, Diphtheria and Pertussis
• flu shot*

*Flu shot included if the flu vaccine is in season, per Centers for Disease Control and Prevention (CDC) guidelines and vaccine availability.

For Children only
a hemoglobin fingerstick screening, vision acuity and hearing test, musculoskeletal assessment, and may also include Measles-Mumps-Rubella booster, Polio booster (IPV).

We have not visited a regular doctor in several years, so I am not sure how these will be performed. I'm not doing this for health reasons...only to fulfill the camp requirements and this was the cheapest I could find. The person I called to make the appt said I can refuse anything I don't want for my DD. She's 10, so the appt scheduler thinks they won't even mention immunizations. I want to be prepared either way. Plus, if I am having to pay for this "screening", is there any good information to be gained?

[lindberg99]

BMI is just calculating a ratio to see if her weight is appropriate for her height. http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html

Skin cancer check is probably just looking to see if she has odd colored moles.

Hemoglobin is checking her iron levels in her blood.

My kids get vision and hearing done at school health screenings. They are just quick screening tests. They also do things like have the kids stand on one leg, hop, etc. Maybe that is musculoskeletal assessment?

[firewoman]

They may suggest she receive the Gardasil vaccine at age 10.  When I took my daughter in at age 9 they wanted to administer it. 

The vision and hearing test is very similar to how they tested us.  At my ped, the nurse holds up an eye chart and has the child cover one eye at a time to test the eyes and the hearing test is given by having the child wear headphones that make beeping sounds on only one side.  The child then picks up a popscicle stick and places it in a basket on the desk in front of them that corresponds with the side they heard the sound in.

The previous poster was correct in her answers about the other tests you were wondering about.  I assume they will check her back for scoliosis and make sure she is on track developmentally.  Should be easy peasy.  They MIGHT want a urine sample, too.

As far as the information gained, hopefully you will just learn that she is healthy and doesn't need anything!

[Mama Metis]

Vaccines you probably have already decided about, one way or another, but I think everything else seems prudent and useful. Yeah, most likely they'll just confirm that she's healthy. But it may also be a good opportunity to start a discussion with your daughter about her body, how to stay healthy, and how to interact with confidence with medical providers (ask questions, express preferences, etc.) Being screened for skin cancer and knowing how to do a self-exam is a very useful skill, particularly if she has any risk factors (pale skin, moles or freckles, living in a climate with a high UV index, etc.) Calculating her BMI will just involve weighing her and measuring her height. Depending on her BMI, the doctor might discuss the importance of a healthy diet and exercise, and/or you and DD can discuss what this means in your family and how to achieve these goals. 

[Panserbjorne]

I wouldn't have a problem with that.  It's a basic review of systems to make sure that everything is as it should be.  There's nothing inherently uncomfortable or invasive (other than the finger stick) that would be worrisome.

[firewoman]

Let me just say that in regards to calculating BMI, the chart is flawed.  My kids are not in any way overweight but according to the charts at my doctors office, they are.  The chart does not take into consideration body composition, it only compares weight to height so even if your child has low body fat but is heavily muscled, some docs will show concern because the BMI is slightly higher than it should be.  I know every office is different but this is something that I have been annoyed with when I have taken my older children in for well child visits.

[sunnysandiegan]

Is the hemoglobin finger-sticking an accurate way to test iron levels?

Thanks for all the answers, mamas!!!

[KempsMama]

Originally Posted by sunnysandiegan 

Is the hemoglobin finger-sticking an accurate way to test iron levels?

Thanks for all the answers, mamas!!!

Yes, I did some looking into this and the margin of error was very low when compared to a full blood draw.  Plus is much less invasive.

[sunnysandiegan]

Thanks!

[sunnysandiegan]

DD had her screening today and it went well. I purposely had her leave her glasses in the car. That part of the exam ended up being rather comical.

Anyway, her hearing test scored 30 in both ears, which is "needs further evaluation" in their ranges. What does this mean in practical terms? The answer I got there was she needs to visit her regular doctor for further evaluation. Not really an answer, IMO. The practitioner checked her ears and there is no wax build-up, which she said is often the cause of this type of score.

I was very happy to see her hemoglobin right in the middle of their 'normal' range, but am wondering if there are other scales for comparison... She has 12.6 g/dl. I have no reason to believe her iron levels are off, but I know with some things there is the medical "normal" and then there is "healthy". Just wondering if this is the case for hemoglobin.

I've decided to ignore the BMI of 15 because I just don't see this measurement tool as being all that helpful.

FWIW, TDap and Gardisal were politely mentioned and when I opted out, it was smooth and easy...never even questioned. I brought DD's yellow immunization cards to the appt, as requested, and it was politely noticed she was on a delayed schedule (seems rather common in this area, actually). I liked the staff and would return to this facility in the future. They were professional and respectful throughout the exam, which was exactly one hour (not the 45 minutes quoted, but exactly what I expected). My favorite off-the-wall thing I liked about this office is it didn't smell like a medical office!

Thanks!

[Aridel]

Originally Posted by sunnysandiegan 

DD had her screening today and it went well. I purposely had her leave her glasses in the car. That part of the exam ended up being rather comical.

Anyway, her hearing test scored 30 in both ears, which is "needs further evaluation" in their ranges. What does this mean in practical terms? The answer I got there was she needs to visit her regular doctor for further evaluation. Not really an answer, IMO. The practitioner checked her ears and there is no wax build-up, which she said is often the cause of this type of score.

I was very happy to see her hemoglobin right in the middle of their 'normal' range, but am wondering if there are other scales for comparison... She has 12.6 g/dl. I have no reason to believe her iron levels are off, but I know with some things there is the medical "normal" and then there is "healthy". Just wondering if this is the case for hemoglobin.

I've decided to ignore the BMI of 15 because I just don't see this measurement tool as being all that helpful.

FWIW, TDap and Gardisal were politely mentioned and when I opted out, it was smooth and easy...never even questioned. I brought DD's yellow immunization cards to the appt, as requested, and it was politely noticed she was on a delayed schedule (seems rather common in this area, actually). I liked the staff and would return to this facility in the future. They were professional and respectful throughout the exam, which was exactly one hour (not the 45 minutes quoted, but exactly what I expected). My favorite off-the-wall thing I liked about this office is it didn't smell like a medical office!

Thanks!

It could be an error, or from something like fluid in the middle ear - does she have a cold, allergies or anything else that may cause congestion?  It's good to follow up, in case there is a true hearing loss there, but since it's just a screening all it really means is that someone needs to check it out.  Some hearing losses can be subtle - the child may hear fine in most frequencies, and have a loss in others, or may have a mild loss for which they compensate well.  Kids can also be nervous with the screenings, and not raise their hand for the very quiet beeps used to detect threshold of hearing, if they're worried they're making a mistake, or there is any background noise in the room. 

Sounds like a great place, and a lot of useful information!

[Llyra]

Agreeing-- my DD1 failed the hearing test, by a slim margin. We had her retested, and she did just fine. What I found out, after talking carefully with her, is that it took awhile for her to fully understand what they wanted, and to be confident that the very soft sounds she WAS hearing were in fact the sounds they were talking about-- she was waiting for something a whole lot louder and more obvious, and was timid about answering when she wasn't sure what she was supposed to be listening for. I'm guessing a lot of these issues could be avoided if they would take more time to talk carefully to kids before they start the test.

Could it be that your DD was confused?

[sunnysandiegan]

Anything is possible. ;)  However, I watched the whole process and the PA did explain it to DD in a way that she seemed to understand. There was no background noise at all in the room. It was a very peaceful silence. My DD did seem a little nervous, though, mostly in her body language and the fact that it was a "test" in her mind and she needed to "pass".

I'll talk to DD about it a little more and see what she has to say. Maybe her teacher and Girl Scout leader, too. They are both sensitive adults who spend a lot of time with her in situations where she needs to listen for instructions, etc. Different perspective from mom and dad.

Meanwhile, I do feel there could be a slight hearing issue. She talks a little louder than necessary pretty much everywhere. Not a lot louder, but enough where DH & I have to remind her to speak softly when she is close to our faces/ears. I don't recall this at younger ages, but rather since Kindergarten. I volunteer a lot in the classroom at school and have since K. I'm torn on if it is a product of the school environment (aka learned behavior) and if it is just becoming more and more noticeable.

The confusing part is she has always been very sensitive to certain noises and can easedrop like no tomorrow! LOL

I think I'll keep digging...

Thanks so much!