• Extensive Medical Interview
• Comprehensive Physical Examination
• Comprehensive Gynecologic Evaluation - for Women
• Men’s Issues
• EKG (electrocardiogram)
• Cardiac Exercise Stress Test
• Pulmonary Function Test
• Metabolic Analysis
• WellScan (Bio-Age Assessment)
• Musculoskeletal Evaluation & Fitness Assessment
• Nutritional Assessment
• Vitamin profile
• Coronary Artery CT
• Ultrasound of Organs
• Bone Health and Osteoporosis
• MRI (Open and Closed) / MRA
• Colonoscopy
• Virtual Colonoscopy
• CBC and Chem 20
• Complete Hormone Panel
• Cardiovascular Risk Panel
• Ferritin
• Thyroid Screening – T4 Free & TSH
• Tumor Markers (CA125, CEA, PSA, NMP)
• Genetic Testing
• HIV Antibody
• Oxidative Stress
• Comprehensive Laboratory Summary
• Vision Screening
• Audiometry
• Personal Health Notebook
• WellMax Health Portfolio and Membership Program
  

· Extensive Medical Interview One-on-one consultation with a board-certified physician allows ample time to discuss your concerns. The physician reviews your personal medical history as well as your family history. There is detailed screening for symptoms relating to all of your body’s systems, including neurological, respiratory, cardiovascular, gastrointestinal, genitourinary and endocrine.

· Comprehensive Physical Examination
The physician completes a detailed checklist while conducting your physical examination. Since all of your data is entered into your personal database, this checklist assures that all necessary components are meticulously collected.

· Comprehensive Gynecologic Evaluation - for Women
The physician takes a comprehensive gynecologic and obstetric history. The physical examination includes ---at the patient’s option --- breast and pelvic examination as well as a ThinPrep™ pap smear. The ThinPrep™ Pap test is a very sensitive test of cervical epithelial cells and is highly accurate in detecting abnormalities. Women have the option of a consultation with Dr. Jennifer Berman to discuss optimizing sexual health.

· Men’s Issues
In addition to the imaging of the prostate and blood tests for testosterone and other relevant hormones, the physician provides the opportunity to discuss sexual issues, and the options for optimizing sexual health.

· EKG (electrocardiogram)
This test is a 12-lead electrocardiogram that measures your heart rate, rhythm, function, and is used as a limited screening tool for cardiovascular disease.

· Cardiac Exercise Stress Test
This test requires a continuous electrocardiogram, which screens for signs of heart disease or palpitations as one walks on a treadmill that gradually slants uphill. This provides a cardiovascular fitness baseline, and screens for early coronary heart disease before you are aware of symptoms.

· Pulmonary Function Test
This test measures baseline function of your lungs, as well as screening for asthma, emphysema, or any obstructive or restrictive lung disease. It includes FEV-1 and FVC (Forced Expiratory Volume and Forced Vital Capacity).

· Metabolic Analysis
This consists of resting energy expenditure and V02 max.
Individuals have enormous differences in these measures that are determined in part by their genes, thyroid function and fitness level.

· Musculoskeletal Evaluation & Fitness Assessment Your assessment includes measures of body composition, joint range of motion as well as flexibility and strength of the adjoining soft tissue structures. A postural assessment will be performed with recommendations to decrease the effects of degeneration on joints and muscles. Gait analysis is used to determine structural abnormalities and muscle asymmetry.

· Nutritional Evaluation You are given forms to document everything you eat for 2 days. Practical and individual recommendations are made to increase the ‘nutrient density’ of your diet and regulate optimal caloric intake. The evaluation includes two reference books: What Color Is Your Diet by David Heber M.D. and Dr. Shapiro’s Picture Perfect Weight Loss 30 Day Plan. A wallet reference guide for fast foods, restaurants and snacks is also included.

· Vitamin profile
If you are taking vitamins and supplements currently, we take the ingredients of your entire regimen and enter it into the WellMax Master Vitamin Spreadsheet to analyze the total amount of each ingredient, and to help identify important nutrients or vitamins that may be missing… especially after your individual medical issues have been identified.

IMAGING TESTS

Carotid Arteries Carotid arteries are the main pipelines of blood to your brain. A silent build-up of plaque can lead to a stroke. If significant plaque is discovered, you then have several options to minimize any further buildup. Our biochemical evaluation dovetails with this test to understand the chemistry processes that cause this plaque.

Ultrasound Screening of the Abdomen

Ultrasonography is a painless procedure that allows us to visualize your liver, gallbladder, pancreas, kidneys, adrenal glands, and aorta.  These areas are viewed using no radiation, unlike X-rays or CT scans.  Using our high technology equipment, we are able to efficiently screen for diseases often before symptoms appear. 

 

Ultrasound of the Thyroid

The thyroid gland sets the metabolic rate for the entire body.  Many disease states are secondary to thyroid abnormalities, and thyroid dysfunction is more common than is generally believed.  Thyroid can have cancer nodules or benign adenomas that produce hormone independent of the thyroid gland.  This ultrasound allows us to assess the size, shape, and texture of this gland, as well as screen for abnormal nodules or cancer.

Women’s Ultrasound of Uterus and Ovaries
Uterine endometrium (the lining inside) often thickens prior to cancer forming, and ultrasound allows us to measure it and follow its thickness. We can also see any wall abnormalities or masses.

Ovarian cancer, like cancer of kidneys or pancreas, can be cured if found early, but is usually fatal because it is usually discovered by symptoms, when it is too large, and too late. Monitoring ovary size and density changes, whether or not a woman is on hormones, brings more information and more security. Remember, most women who have the uterus removed do not have the ovaries removed, and it is difficult to palpate ovaries well enough to detect abnormalities that can be found much sooner with ultrasound.

Men’s Ultrasound of Prostate
Obtains a baseline study of prostate size, shape and architecture. It screens for prostate cancer. This study includes bladder imaging and a “post-void residual”, i.e. the technician measures the volume of urine remaining in the bladder immediately after voiding. It helps to assess urine retention due to larger prostates.

· Bone Density Testing WellMax uses cutting-edge Hologics 4500W bone densitometry equipment. DEXA bone density measurements are taken at several levels of the vertebral column, and several areas of the hip, as well as a performing a whole body scan. The results are immediately available. Body composition is accurately measured. The body fat content is calculated for each area of your body, including total body fat.

· Whole Body MRI (Magnetic Resonance Imaging)

This test allows your doctors to see the interior of your body --- your brain, liver, pancreas, everything --- in 3D with no radiation.

MRI is one of the best imaging modalities because of its superior contrast differentiation between muscle, fat, vessels, tendons, ligaments, cartilage, and bone. The benefits of MRI are many, with new applications continually being developed through ongoing research. Women have complete visualization of the uterus and ovaries, screening for uterine and ovarian cancer, polyps, fibroids and more. MRI in men includes a baseline study of prostate size, shape, and architecture. It screens for prostate cancer. The Whole Body MRI includes images of the bladder and the surrounding pelvis. This bladder test, in conjunction with the Nuclear Matrix Protein urine test, is the most advanced, sensitive test available for detecting bladder cancer. You receive a 3-D picture that can be saved to your private, password-protected CD, and soon we expect to offer you a secure personalized website.

· MRA
Whole Body MR Angiography (MRA) is an MRI study of the blood vessels, with no radiation. MRA detects and aids in the treatment of heart disorders such as PVD (Peripheral Vascular Disease), stroke, renal artery disease leading to hypertension, and blood vessel diseases. MRA provides very sharp and detailed images, so it can detect tiny changes from the normal pattern, including aneurysms and plaque. At WellMax we use MRA routinely to look at the health of ALL your blood vessels, including the brain, the carotid arteries supplying the brain, as well as the aorta, kidney arteries and other important blood vessels, down to the femoral arteries supplying the lower legs.

· Coronary Artery CT Specialized computer software is used in conjunction with detailed imaging of the coronary arteries of the heart, to determine a "calcium score." This score correlates with the amount of atherosclerotic plaque in the coronary arteries. In general, the higher the calcium score, the greater risk of a heart attack. It does not require any needles or probing.

· Lung CT Screening for lung cancer or other abnormalities in the chest is performed at the same time as the Coronary Artery CT. Recent research confirms the markedly improved ability to detect lung cancer in the earliest curable stages with this technology. This is especially important in any patient who smokes or who once smoked.

· Virtual colonoscopy OR conventional colonoscopy

· Virtual This virtual examination can be included with the rapid spiral CT scan. After external scanning, the computer generates images of the colon lining to scan for polyps or masses that might give rise to cancer. Bowel Prep beginning the day before is required for this test.

· Conventional This procedure is the gold standard of directly visualizing the colon with a fiber-optic scope while you are lightly sedated. If a polyp or mass is discovered a biopsy can be taken immediately so treatment or follow-up can proceed quickly. Bowel Prep one to two days prior to this procedure is required.

LABORATORY TESTS

· CBC and Chem 20
A complete blood count (CBC), twenty chemistry measures (Chemistry 20 panel), which includes measures of liver and kidney function, fasting glucose (blood sugar), and electrolytes.

· Complete Hormone Panel
Serum DHEA-S, estrogen (estradiol extraction), testosterone (“free,” total, and “bioavailable”), growth hormone (via IGF-1) and cortisol for both men and women. For men, there is also a measure of DHT (dihydrotestosterone) and LH (luteinizing hormone from the pituitary). For women, there are additionally measures of progesterone and FSH (follicle stimulating hormone from the pituitary).

· Cardiovascular Risk Panel
Medical Scientists have discovered many modifiable risk markers for heart disease. Cholesterol is just the tip of the iceberg. Our cardiac panel includes the usual lipid panel of cholesterol, HDL, LDL, and triglycerides. In addition, the type of HDL and LDL are checked, since it makes a big difference in your individual rate of arteriosclerosis. Lipoprotein (a), highly sensitive C-reactive protein, homocysteine, and fasting insulin are measured. Fibrinogen and others can be added for high-risk individuals.
Under “research” we can also offer unique markers like MPO (myeloperoxidase), thought to be far more predictive of heart risk than the other tests. Together these many tests provide your individual and unique pattern of cardiac risk markers. These can be modified!

· Ferritin
Ferritin serves as a general screen for both iron deficiency and iron overload. Problems with iron shortage and iron storage in the body are much more common than previously recognized. If this test is abnormal, a panel of iron measures can be ordered to clarify exactly what the problem is.

· Thyroid Screening – T4 Free & TSH
These two tests measure the function of the thyroid gland and its ongoing “dialogue” with the pituitary gland. Thyroid hormones control the body’s metabolic rate. We can also, if needed, measure serum total and free T3, a different, more active form of thyroid hormone converted peripherally from T4.

· Tumor Markers (CA125, CEA, PSA, NMP)
These markers screen for ovarian cancer, colon cancer, prostate cancer and bladder cancer, respectively. NMP is not generally available in other clinics.

· Genetic Testing
All human diseases are caused by the interaction between genetic predisposition and modifiable environmental factors. With this knowledge you are given a ‘glimpse’ into your potential health future. Genetic testing empowers the physician to help the patient reduce the risk of disease without waiting for symptoms to appear by using earlier, more precise and customized interventions.

New genes are being made available for testing every few weeks. Currently, a baseline genetic analysis includes a cardiovascular risk panel (Cardio profile) and a detoxification gene panel (Detox Profile). The Cardio profile checks eight different genes to uncover potential genetic susceptibility to elevated cholesterol, arteriosclerosis, obesity, high blood pressure, heart attacks (coronary artery disease), blood clots (thromboses), and stroke. The Detox Profile checks over 20 genes to uncover genetic susceptibility to adverse drug reactions, numerous cancers, neurodegenerative disorders, mood disorders, fatigue syndromes, fibromyalgia, multiple chemical sensitivity and oxidative stress.

· HIV Antibody
This test screens for the human immunodeficiency (AIDS) virus.

· Oxidative Stress
These optional measures of one’s oxidative stress are currently considered “research.” They can provide enormous insight into your body’s physiology. We also measure oxidized and reduced glutathione, and their ratio. We measure TBARS, and oxidized LDL, paraoxinase (PON), and F2 isoprostanes. These tests can generate enormously valuable information about your body’s defenses against aging and degenerative diseases. Specific therapies (usually nutrients) are available to modify these values.

· Comprehensive Laboratory Summary
Your results will be entered into a spreadsheet so that you can easily see all of your tests summarized, and see how they change over time, since columns are in place for dates. All the labs are analyzed by the physician and reviewed with you in a comprehensive, individualized letter, and by telephone.

· Vision Screening We measure visual acuity at near, intermediate and distant vision, and screen for color discrimination, heterophorias, and more. Dr. Cosgrove is an FAA Medical Examiner, and this equipment is certified for FAA pilot evaluations.

· Audiometry
This hearing test screens for hearing loss at several frequencies in the conversational range. Dr. Cosgrove is an FAA Medical Examiner, and this equipment is certified for FAA pilot evaluations.

· WellScan This 45-minute test uses a computer, a microprocessor, and several instruments to assess 12 "biomarkers of aging". These markers include visual accommodation, auditory and visual reflexes, high frequency hearing, pulmonary function, vibro-tactile sense, memory and other functions. Regression analysis is used to compute your "biologic age". If significant problems are discovered in one or more areas, further testing may be done.

· Personal Health Notebook A personalized, comprehensive notebook is prepared for you with details of all of your studies, copies of reports, and our recommendations. You may have this information summarized onto a personalized CD, and soon we will offer an individual secure website accessible only to you and those doctors for whom you delegate access.

· WellMax Health Portfolio and Membership Program
These programs allow your healthcare to be a process, not an episode. It allows us to partner with you over time to improve the many measures listed above. We can increase bone density, lower oxidative stress, improve pulmonary function, etc. Measuring becomes a starting point for change.