The Adulting Handbook, Part 1: Medical Tests & Screenings

Quick disclaimer before we start: I’m not a doctor, and nothing here is medical advice. I’m a software developer who has spent a lot of time in hospitals and clinics, learning things the hard way. This is a well-researched cheat sheet. Use it as a starting point for conversations with your own physician.

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TL;DR, Quick Reference Table

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The Annual Physical Exam: What Should Actually Be In It

Here’s something I didn’t know for years: not all APEs are created equal. The one your employer sends you to annually might cover the bare minimum, and you’d never know what’s missing unless you ask. Here’s what a complete APE should include.

Blood Work to Ask For

CBC (Complete Blood Count) Your baseline. Checks for anemia (hi, it me), infection, and clotting issues. Almost always included in a standard APE, but always confirm.

Fasting Blood Sugar (FBS) Your baseline diabetes marker. You fast 8-10 hours before this one.

HbA1c A longer-term snapshot of your blood sugar over approximately three months, more telling than a single FBS reading. Ask for it starting in your 30s, or earlier if you have risk factors.

Lipid Profile Total cholesterol, LDL (“bad”), HDL (“good”), and triglycerides. Heart disease doesn’t announce itself early. That’s exactly why you check.

Uric Acid Gout risk and kidney health. Worth including in your annual labs, especially if you eat a lot of meat or seafood.

BUN & Creatinine Kidney function markers. You want these in range long before there’s any reason to worry.

SGPT / SGOT (ALT/AST) Liver enzymes. Flags liver stress, relevant if you drink or have ever drunk regularly, or are on long-term medications.

TSH (Thyroid Stimulating Hormone) I feel strongly about this one. Thyroid problems are far more common than people realize, especially in women, and the symptoms are so easy to dismiss: fatigue, weight changes, mood shifts, feeling cold all the time, hair thinning. They wear a lot of disguises. I wish I’d gotten this checked routinely much earlier. Ask for it specifically; it’s not always included by default.

Urinalysis Kidney and urinary tract health. Standard in most APEs.

Ferritin This is separate from hemoglobin on the CBC, and it measures your iron stores rather than just what’s circulating right now. If you have a history of anemia or unexplained hair thinning, this is the one to ask for specifically, it often gets missed.

Physical Checks

• Blood pressure
• Heart rate
• BMI and weight - and if you’re consistently underweight like I was, bring it up. Underweight isn’t automatically healthy, and it comes with its own set of risks.
• Temperature and respiratory rate if symptomatic

Imaging Often Bundled in APEs

• Chest X-ray - usually annual for smokers; every 2-3 years otherwise
• ECG - see below

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ECG / EKG (Electrocardiogram)

An ECG captures a snapshot of your heart’s electrical activity. It can detect arrhythmias, an enlarged heart, and even signs of a silent heart attack - yes, those exist.

• When to start: Your 30s is a good time for a baseline, especially with any family history of heart disease
• Frequency: Every 2-3 years in your 30s-40s; annually after 40, or sooner if you have hypertension, diabetes, or high cholesterol
• What to expect: Completely painless. Electrodes on your chest, done in minutes

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Blood Pressure

Simple but critical. High blood pressure is called the “silent killer” because there are usually zero symptoms until something goes wrong.

• Normal: Below 120/80 mmHg
• Everyone 18+ should check this at minimum annually
• If your readings are consistently elevated, your doctor will want to monitor more frequently

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Blood Sugar & Diabetes Screening

The Philippines has one of the highest diabetes rates in Southeast Asia. Early detection changes outcomes significantly.

• FBS: Get a baseline in your early 20s, especially with family history
• HbA1c: Start at 35, or earlier if overweight or high-risk
• Frequency: Every 3 years if normal; annually if pre-diabetic

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Cholesterol & Lipid Panel

High cholesterol has no symptoms. You will not feel it, that’s the whole problem.

• Start: Ages 20-25 as a baseline
• Frequency: Every 5 years if all values are normal with no risk factors; annually if elevated

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Thyroid (TSH)

This one is personal. Thyroid problems are sneaky, common, and regularly dismissed, particularly in women. Fatigue, weight fluctuations, hair loss, mood changes, temperature sensitivity. All of those can be thyroid. And if you’ve had thyroid surgery or cancer, TSH monitoring is lifelong and non-negotiable.

• Baseline: Consider starting in your 30s, or earlier if symptomatic
• Frequency: Annually if on medication or with history; every 3 years if normal

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Pap Smear & Cervical Cancer Screening

One of the most consistently skipped tests, and it genuinely saves lives. Cervical cancer caused by HPV is almost entirely preventable with regular screening and vaccination.

• When to start: Age 21, or within 3 years of becoming sexually active, whichever comes first
• Ages 21-29: Pap smear alone, every 3 years
• Ages 30-65: Pap smear + HPV co-test every 5 years (preferred), or Pap alone every 3 years
• After 65: If prior screenings have been consistently normal, you can likely stop, confirm with your OB-GYN

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Breast Cancer Screening

• Self-exam: Monthly from your 20s. Know your own normal, any new lumps, changes in shape, skin dimpling, or nipple changes are worth flagging to your doctor
• Clinical breast exam: Every 3 years in your 20s-30s; annually from 40
• Mammogram: Start at 40 for average risk; earlier if you have a first-degree relative who had breast cancer

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Colorectal Cancer Screening

Colorectal cancer is one of the most treatable cancers when caught early, and one of the most avoidable to catch late.

• When to start: 45 for average risk; 40 with family history
• Colonoscopy: Every 10 years if results are clear
• FIT (stool-based test): More frequent alternative if colonoscopy isn’t accessible

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Eye Exam

Your eyes aren’t just about whether your glasses prescription changed.

• 20s-30s: Every 2-3 years; get a baseline at 20 even with good vision
• 40+: Annually - glaucoma and macular degeneration risk increases with age
• If diabetic: Annually regardless of age - diabetes can damage the blood vessels in your eyes

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Hearing Test

Hearing loss is gradual and easy to miss until it’s significant. Noise exposure, earphone use, and aging all contribute.

• Baseline: Age 21
• Frequency: Every 10 years in your 20s-40s; every 3 years after 50

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Bone Density Scan (DEXA)

• Women 65+ should get this routinely
• Earlier if: consistently low body weight (lower bone density is a real risk for underweight individuals), history of eating concerns, long-term steroid use, early menopause, or family history of osteoporosis
• Asian women have a higher baseline risk for osteoporosis, worth raising with your doctor in your 40s

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STI Screening

No judgment. If you’re sexually active, this is just part of looking after yourself.

• HIV: At minimum once as a baseline; annually if high-risk
• Hepatitis B & C, syphilis, chlamydia, gonorrhea: At least annually if sexually active
• Most are simple blood or urine tests. Knowing is always better than not knowing.

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Full-Body Skin Check (Dermatologist)

This isn’t just skincare, it’s cancer screening.

• Annual full-body check starting in your 30s
• Your dermatologist is looking at moles, lesions, and any changes that could indicate early skin cancer
• Monthly self-check: Look for the ABCDEs: Asymmetry, Border irregularity, Color variation, Diameter larger than 6mm, Evolution (change over time)

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Next up: Part 2: Adult Vaccines. Because no, your childhood shots aren’t enough.