Many people assume that I must be a hypochondriac. This is due mainly, I think, to my being a 41-year-old Jewish male, a demographic who have to spend most of the day obsessing about their health.
The fact that I wear glasses, have spent a fair amount of my career complaining about stuff in general, and tend to say “hello” on the telephone in a way that always sounds as if a doctor has just handed me a cancer diagnosis doesn’t help. However, the truth is, I’m not.
Most of the time, in fact, I assume a default position of health and, if I do get ill, am slightly outraged by it. OK, once, when I was 22, I noticed — never mind why — a bit of gristle in my testicles and immediately assumed that it was a tumour only to be told a few days later by the (clearly-convinced-that-I’d-just-come-in-to-have-them-cupped-by-her) examining nurse that gristle is essentially what the testicles are made of. But that was when I was young and overprotective of that area.
So why, you might ask, did I agree to go and give myself a complete once-over at Preventicum? This is not, as some people I told seemed to think, a place you might go to combat premature ejaculation, but the London Centre of Preventive Medicine: a private establishment devoted to providing the “most advanced and safest radiation-free full-body check-ups to individual and corporate clients”.
Well, two reasons. First, I wasn’t paying. It costs a whopping £2,750 for a non-newspaper-associated citizen to have his or her body passed over with Preventicum’s medical fine-tooth comb and, in truth, I find it hard to resist getting anything for that amount of money for free. Second, I thought about the nice feeling of relief that might come with knowing that your body was free of major disease. Which, by the way, proves that I’m not a hypochondriac: if I was, the second reason would have been about catching the lump, cyst or polyp that I know I’ve got somewhere before it eventually mutates into something fatal.
Of course, that doesn’t mean that I didn’t have any of the said lumps, cysts or polyps, simply that I didn’t go in the expectation of finding them. You’ll just have to read to the end of the article to find out if, as it turns out, I’ve got four weeks to live.
What happens when you go for a Preventicum check-up is this. You go to a faintly Star-Trekky floor in a building in Shepherd’s Bush, West London, and are shown into a very nice room, with large sofas and a plasma screen, and told to change into their comfy white pyjamas and slippers. Then you meet Dr Garry Savin, the head of the organisation, who will ask you questions about your medical history and give you a basic hands-on check-up. After that is an ECG, a blood test, a urine test, an ultrasound, and — Preventicum’s centre-piece — an MRI (magnetic resonance imaging) scan, which takes hundreds of images of the inside of the body without any known side-effects.
This all takes about four hours, after which Dr Savin and Dr Kandyba (yes, Dr Kandyba: I have no idea if his first name is Cadbury’s), a consultant radiologist, will take you through all the results.
If it all sounds like a medical form of pampering, there are drawbacks. Number one on the list is that, for your colon to show up clearly on the MRI scan, it has to be empty. That means that for two days beforehand you’re not allowed to eat any fibre; from lunch the day before you can’t eat anything; and all through this time you have to take a laxative. I’m not sure that I can go into the details of what happened to me under this regime, but , suffice it to say, I thought about moving my computer, television and eventually children into the toilet, so as to carry on my life more easily from there.
Number two on the list is that not only does the colon have to be empty but it also has to be filled with water — from behind. Now I’ve had colonic irrigation, once, and that was bad enough, but at least that was performed by a kindly, if slightly deaf, old lady. This time the person concerned was a burly Englishman who dealt with any resistance to tube insertion by the use of brute force. While this was happening, at my other end my hand was being held by a nice Australian lady and, if you’re reading this, can I just apologise now for the tears.
The MRI scan goes on for about an hour and a half, during which you are put into the scanner (a huge cylinder full of magnets) in various positions. The boredom was relieved, however, by going into the computer room in between each scan (head, stomach, legs, heart, etc) and seeing for the first time what I looked like under the skin. An MRI scan, I should say, gives you a lot more to look at than an X-ray. First, of course, it’s the whole body, and second, you get to see whichever part you’re looking at in 360 degrees. This is fascinating, if a little bit like an extreme form of navel-gazing. They can animate your heart so that you can see it beating; they can bring your intestines slowly into view so that your stomach area changes from a skeletal set of ribs to what appears to be a house of worms.
The most interesting, and most disturbing, are the head pictures. Seeing my own brain was weird enough — so like a walnut — but from the side it was also very clearly my profile, with brain on show. The animation of that was, I have to say, horrible. The playwright John Webster, T. S. Eliot once said, saw the skull beneath the skin, but I bet he never saw a virtual tour around his skull in which his profile very quickly mutated into a zombie’s face, all bulging eyes and hanging organs.
After that, you go back to your room, and — best part of the day — they bring you some food and a cup of tea. Then it’s time for the final consultation with Dr Savin and Dr Kandyba, during which they take you through all the test results to give you one more update on your mortality. I asked Dr Savin what it’s like when they find something bad and he explained that people are generally pleased: they are glad they found out and so have time to do something about it. In general, Preventicum feels, everyone should have one of these check-ups every two years; everyone, that is, who’s got £2,750 to spare. I have no doubt, however, that if you can afford it, it’s a good thing to do.
Oh, and did they find anything? Yes.
Some fecal matter in my colon. Can you believe it? All that effort for nothing. But apart from that, a radically clean bill of health, including cholesterol levels so low that Dr S asked if I was taking cholesterol-lowering drugs (I’m not). Hooray, but I knew it; as I say, I’m not a hypochondriac. If I was, I’d be telling you now about the fatal lump they found with just a slight element of smugness.
Remember the hypochondriac’s epitaph: I told you so.
Getting value for money
Private health screens are available at many places around the country, but what can you expect to get for your money?
£50-£250 Screening packages in this price range just cover the basics. If you’re really counting the pennies the Diagnostic Clinic in London offers a “questionnaire-based health assessment” for £50. It involves you filling it in, sending off your money, and getting their suggestions e-mailed back to you.
If you want more than a questionnaire, the Diagnostic Clinic and Medicentre, also in London, offer basic screening at £120. This covers height, weight, body mass index, blood pressure, pulse and lung capacity. For £200, the Diagnostic Clinic offers an upgrade: taking blood, urine, saliva and fitness tests.
£250-£500 These pricier assessments include a consultation with a doctor; and the more you pay, the more they check. The deals in this price range include full physicals, hearing and vision tests, checks for diabetes and cholesterol, and lung and kidney function. Pay above £200 and many companies, such as BUPA, Nuffield Hospitals and BMI Healthcare offer packages tailored to men and women. The women’s packages focus on breast and cervix (examinations, mammograms and smears), and the chaps on testicals and prostates.
For those who prefer to take an alternative route, the Diagnostic Clinic offers a complementary and alternative medicine screen, for £330. This includes an assessment by an osteopath and a hair mineral analysis.
£500-plus Options here go under headings such as “premier”, “gold”, “VIP”. At BUPA, the main difference between its standard “classic” package and its top one is a cardio- respiratory exercise test. The Diagnostic Clinic also offers two consultations with a doctor and a written report, which is sent to your regular doctor.
Further details David Baddiel was screened by Preventicum, London Centre of Preventive Medicine (020-7605 6900, www.preventicum.co.uk). Health screens are also available from: Nuffield Proactive Health (08452 302040, www.nuffieldproactivehealth.com). BUPA (0800 600500, www.Bupa.com). BMI Healthcare (020-7009 4500, www.bmihealthcare.co.uk) The Diagnostic Clinic (020-7009 4650, www.thediagnosticclinic.com) Medicentre (0870 6000870, www.medicentre.co.uk)
KATE WIGHTON
Do we need screen tests?
What should you look out for in private health screens?Dr Angela Raffle, a consultant to the NHS National Screening Programmes, has the answers
Why bother?
Remember that private health screening is a commercial venture. You have to ask yourself what is it that you really want. Then ask yourself whether private health screening is the best way of achieving this.
Are some people better suited to private health screens?
The people most likely to want health screening are those who are relatively well and health-conscious. Often people go because they want the reassurance of a normal test result rather than because they expect anything to be wrong. If you have specific health worries, it is best to consult your doctor. Some screening is routinely available in the NHS: blood pressure checks, cervical and breast screening, antenatal screening, heart disease assessment, eye checks for people with diabetes. Having them on the NHS means that they are part of a co-ordinated programme with follow-up and continuity of care. The advantage of seeking tests privately is that you may get more time with the doctor.
How do you choose the right one?
If you want expert help in assessing your lifestyle and general physical fitness, look for a health screen that measures cardiovascular fitness (blood pressure, pulse and heart rate), with and without exercise, and gives you plenty of time, one- to-one with an experienced counsellor. If you want to have more detailed knowledge about the workings of your body, involving blood tests, heart traces and scans, look into this carefully. You could be wasting your time and money and, at worst, you may be found to have something “wrong” that, in fact, would never have troubled you, putting you at risk of side-effects from investigations and treatments that you don’t really need.
Look carefully at the information provided by the screening organisation. Be cautious if it is vague about what conditions the screen is aiming to reduce the risk of, and if it fails to mention any limitations or drawbacks. Many tests that are commonly performed in health screens for healthy people are poorly backed by evidence indicating that they save lives: for example, the PSA test for prostate cancer, exercise electrocardiogram tests (sometimes called the “exercise stress test”), and whole body scans using computerised tomography (CT) or magnetic resonance imaging (MRI). Even more suspect are tests such as “live blood analysis” and electrodermal testing devices.
What are the key questions?
The best screening clinics will welcome questions and will regard it as essential that you understand exactly what each test is designed to pick up, what happens next if abnormalities are found, and what the limitations of each test are. The key questions for each test are:
What training and quality control procedures is there for staff performing the tests?
