Isn't it time to get yourself an MOT?

Author Unknown
Last Updated: 12:01am GMT /02/2002

A FEW months ago, I called Dr Andrew Melhuish from a service station off the M4 and told him I was having a heart attack. I was slumped in the front seat of a car, struggling to breathe, feeling disorientated and tingles were running up both arms. My palms were sweaty and a tightness stretched across my upper body as if someone was pressing down on my shoulders.

"Do you have a pain in the chest?" he asked.

"No," I said.

"Is the tingling definitely in both arms?"

"Yes."

"And is your breathing shallow?"

"Yes, very."

"Then, you are not having a heart attack. You are hyper-ventilating. It's some kind of a panic attack. Your body has closed down but you're not going to die. When you're feeling better, it may be a good moment to come for a check-up and we'll talk about it."

The last time I had seen Dr Melhuish was nearly four years ago when I booked in for one of the Ł250 medicals which he conducts from his home near Henley-on-Thames. A former GP and the author of Perfect Executive Health: All You Need To Get It Right, Dr Melhuish, a trim-looking 66, is an impassioned believer in regular check-ups. His view is that anyone between the ages of 20 and 40 should have a full medical once every two years and the over 40s should have one without fail every 12 months.

Several companies and organisations, including the Lovell Partnership, Instrom Technical Indexes and the University of Luton, send their top executives to him and he is on a crusade to persuade more women to undergo regular tests rather than aping their male colleagues who tend to shy away from the idea.

"Women managers generally look after their health better than men but many of them feel they have to adopt a male way of life in order to advance their careers and then they start worrying about what it's doing to them. A lot of women I see describe difficulty sleeping, which few men do."

It seems absurd that we spend up to Ł400 having our cars serviced once a year but balk at the idea of a human MOT. But part of the problem is that GPs are far too stretched to get involved with preventative medicine. "We don't have a National Health Service, we have a National Illness Service," says Dr Melhuish.

"We only see a doctor when something is wrong. In France and Germany you are encouraged to go for regular check-ups in the same way that we go and see the dentist or optician. Which is so sad because heart disease and early diagnosis of cancer is far more important than toothache. In Japan, most adults have their own blood pressure machines."

Sally Hookham, managing director of The Food Business, a product development company based in St Albans, Hertfordshire, started seeing Dr Melhuish 15 years ago when she was in her early 30s. She now makes an appointment every 18 months. "I feel I have a responsibility to my family and to the people I employ. I want to know that as I get older my body is still functioning properly. My father had coronary problems when he was in his 50s and I am keen not to go down the same route. I really look forward to coming. It's like catching up with my life and Andrew is brilliant at getting things in perspective. He helps me understand how the body works."

The examinations last two and a quarter hours, of which the first half involves chatting about one's life while Dr Melhuish takes notes. What someone has been experiencing emotionally helps him to know what to look for physically. Some of the questions he asks are acutely personal but there is no obligation to answer. And yet most people do. He is a sympathetic listener, not least because his own life has not been without difficulty. His first wife walked out on him, taking their young children after she fell in love with another man. It came as a complete surprise.

"I know what real pressure can do to people and I know that talking about it can burn away the worst of it," says Dr Melhuish, who has since remarried and has two more children, both teenagers. "For a lot of the time, adrenaline protects us. It drives us on and makes us think we're coping but eventually the body will rebel. That's why adrenaline junkies get ill when they go on holiday. Take their fix away and they fall apart."

After an hour of conversation, Dr Melhuish checks ears, eyes, throat, lungs, bones, muscles, skin, weight, pulse, takes a urine and blood sample and, then, attaches various wires to the chest in preparation for an electro-cardiogram. He takes one reading before exercise and one after you have completed five minutes going up and down two steep steps as fast as possible. The aim is to double the pulse.

About a week later, he sends you a detailed four-page report, complete with two sets of the blood and ECG results, one of which he hopes you'll send to your GP.

Despite my motorway service experience - and the discovery that I am two stone heavier than when I first saw him in 1985 - my results were better than expected. He wants me to cut out the occasional cigar because he knows very well that what I call occasional has become rather more frequent. But the liver is coping well with my alcohol consumption and there's no need to give up butter quite yet.

"There are a few absolute dos and don'ts in maintaining good health but half the battle is managing pressure, and a lot of that comes down to making certain choices," says Dr Melhuish.

"Worrying about health is a pressure but it needn't be. Going for a regular medical should be something we do as a matter of course. Many of the illnesses from which people die are increasingly easy to diagnose and to treat effectively. It's tragic that medicals aren't a natural part of our culture," he says.

Dr Andrew Melhuish, tel: 01491 574701