EXECUTIVE HEALTH. Carotid Ultrasound (Carotid intima-media thickness) * Cardiac stress test*

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Maria Shelton
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1 Focused Stay: Executive Health Program EXECUTIVE HEALTH We welcome you to the Canyon Ranch Executive Health Program at Kaplankaya. This program offers both a comprehensive assessment and a portal to experiencing your best health and wellness. This program is above and beyond the traditional history and physical it is an integrative program that brings together the best of internal medicine with an exploration of both mental stress and emotional health in addition to optimal next steps for exercise, nutrition and sleep. In collabortation with our internists, exercise physiologists, nutritionist and behavioral psychologist, you will connect to your health in a renewed way within the luxury of Kaplankaya and its state-of-theart facilities. We are passionate about helping our guest experience and live their best health by jointly establishing health goals and developing specific, measurable next steps. Executive Health Program over 3 days at Canyon Ranch allows for the testing and set of personalized recommendations that is core to our program. At least 7 days will be helpful to create a deeper experience of living and fine-tuning your individualized plan. With additional time and space for an experience, the program will honor your physical health as well as your mental, emotional, and spiritual wellness. Consultations included: Program overview & intake with nurse (pre-arrival phone call) Initial physician consultation (History and Physical Examination) Exercise physiologist consultation & Metabolic assessment 2 x Nutritionist consultation 2 x Life management consultation Physician wrap-up consultation Follow-up phone consultation Screening Tests included: Comprehensive laboratory screening testing Varies Pulmonary Function Test 15 minutes Resting ECG 15 minutes Carotid Ultrasound (Carotid intima-media thickness) * Cardiac stress test* Varies Abdominal ultrasound* 30 minutes Thyroid Ultrasound* Eye examination (ophthalmoscopy, visual acuity test, tonometry) * Hearing evaluation (audiometry, tympanometry) * DEXA body composition analysis and osteoporosis screening* Package Price Men: 18, Women: 18, (Turkish Lira) Additional recommended tests may include gynecological examination, PAP smear, mammogram, breast ultrasound, cardiac calcium scoring, lung CT scan, and colonoscopy. Fees can be provided upon request. *Testing takes place with our hospital partners in Bodrum. Transportation fees are variable and not included. The Focused Stay is an additional cost to the resort stay. The total prices include VAT. 1

Lectures: Our Health and Wellness team will present lectures on Stress Management, Sleep Health, Ergonomics Tips, Weight Management, Smoke Cessation, Time Management and Optimal Living.

What are the benefits of the Executive Health Program? When medicine is both personalized and individualized in a comprehensive manner, we are afforded the very best of health care.

2 Lectures: Our Health and Wellness team will present lectures on Stress Management, Sleep Health, Ergonomics Tips, Weight Management, Smoke Cessation, Time Management and Optimal Living. Group Activities: Canyon Ranch Wellness Resort at Kaplankaya offers a variety of daily group activities which support a healthy lifestyle such as hiking, swimming, Yoga, Pilates and Fitness classes. What are the benefits of the Executive Health Program? When medicine is both personalized and individualized in a comprehensive manner, we are afforded the very best of health care. While the modern medicine experience is focused on diagnostics and diagnosis, this approaches limits us to a sick versus not-sick perspective. Our goals are to go beyond not sick. Living a life of health, wellness and joy is the ultimate opportunity for each of us. With the platform of internal medicine, you will be assessed by the best of modern medical science. As we recognize the importance of physical wellness, we also look to understand our health from perspectives of mental, emotional and social well-being. This sets up the key next step of experiencing and translating exercise, nutrition and sleep into our daily lives. With all of this, we are set to experience the very best of personalized and individualized health care. Your Executive Health Program Focused Stay includes the following consultations: PROGRAM OVERVIEW AND INTAKE WITH CANYON RANCH NURSE We look forward to welcome you to executive health program on a pre-arrival phone call. In collaboration with a Canyon Ranch nurse, you will be given an overview of the executive health program and complete an intake focused on your medical history with the nurse. In addition, the nurse can assist in reviewing activity options and spa opportunities for a complete Canyon Ranch visit. (complimentary) 2

INITIAL PHYSICIAN CONSULTATION A detailed medical history and physical examination with a Canyon Ranch physician will launch your executive health program at Kaplankaya.

Please bring all and any medical records, especially those completed in the past year. In partnership, you will discuss a personalized strategy targeting your optimal weight and optimal health.

3 INITIAL PHYSICIAN CONSULTATION A detailed medical history and physical examination with a Canyon Ranch physician will launch your executive health program at Kaplankaya. You will discuss options for blood reports and specialized testing as it relates to your current health and goals for optimal health. Please bring all and any medical records, especially those completed in the past year. In partnership, you will discuss a personalized strategy targeting your optimal weight and optimal health. EXERCISE PHYSIOLOGY CONSULTATION AND METABOLIC EXERCISE ASSESSMENT Discover your aerobic fitness level (VO 2 max) with a machine used at NASA to assess astronauts, and learn how many calories you really burn when you work out. This service is recommended for people who want to change body composition, learn the most effective way to burn body fat, determine aerobic threshold, increase stamina and fitness or improve sports performance. Part I A Canyon Ranch exercise physiologist administers a submaximal exercise test while you exercise on your choice of cardiovascular exercise equipment: elliptical trainer, rowing machine, stationary bike or treadmill. Note: This test cannot be performed in a pool. Part II After analyzing the data, your Canyon Ranch exercise physiologist will explain your results and design an exercise program to maximize your workout and enhance your training program. 3

NUTRITIONIST CONSULTATION This consultation gives you nutrition strategies for achieving and sustaining optimal health.

Part II You will receive personalized recommendations, eating plan, and tips for mindful eating. Includes an estimate of your calorie needs.

During this session, you ll work with a psychologist and/or physician to explore your health goals and create a personalized, realistic plan for success.

4 NUTRITIONIST CONSULTATION This consultation gives you nutrition strategies for achieving and sustaining optimal health. Part I A Canyon Ranch nutritionist assesses your weight history, current diet, eating patterns, lifestyle factors and health issues that influence your weight. Part II You will receive personalized recommendations, eating plan, and tips for mindful eating. Includes an estimate of your calorie needs. LIFE MANAGEMENT (BEHAVIORAL HEALTH) CONSULTATION In a private conversation, space and time is scheduled to discuss topics such as memory, stress and/or behavioral change. During this session, you ll work with a psychologist and/or physician to explore your health goals and create a personalized, realistic plan for success. WRAP-UP SESSION Meet with a Canyon Ranch doctor to review integrate your consultations into a program prior to departing Canyon Ranch. We will clarify intentions and focus on next steps based on your medical, exercise, nutrition, and life management sessions. This is key towards achieving your goals of optimal health and optimal weight. 4

Your Executive Health Program Focused Stay includes the following screening tests: COMPREHENSIVE LABORATORY TESTING Blood work and other laboratory tests can be used to track and trend health

5 FOLLOW-UP PHONE CONSULTATION Before returning home, we will schedule an appointment within the next four-weeks. This consult may be with any one of the practitioners you met with during your wellness program. Your Executive Health Program Focused Stay includes the following screening tests: COMPREHENSIVE LABORATORY TESTING Blood work and other laboratory tests can be used to track and trend health parameters. It is important to check these routinely in order to maintain health and proactively reduce risk of medical disorders. Early detection of risk factors can provide opportunities for lifestyle recommendations and/or early intervention towards optimal health and healing. We recommend comprehensive review to include: inflammation, cholesterol, glucose, thyroid, vitamins and minerals, kidney functions, and liver markers. Upon individualized and personalized review, we recommend additional tests and evaluations. Time Varies. PULMONARY FUNCTION TEST Pulmonary Function Test measure lung capacity & flow rates and assess the baseline lung function. 25 Minutes. RESTING ECG Electrocardiography (ECG) is used to record the electrical activity of the heart and to evaluate as to the history of myocardial ischemia and infarction. In addition, this test most accurately determines heart rate and assesses the rhythm. 15 minutes. CAROTID ULTRASOUND (CAROTID INTIMA MEDIA THICKNESS) * Ultrasound Carotid Intima Media Thickness (CIMT) is a measurement of the thickness of the innermost two layers of the wall of carotid artery. CIMT is used to detect the presence of atherosclerotic disease and, to track the regression, arrest or progression of atherosclerosis. Ultrasound is extremely safe because it uses sound waves to produce pictures, does not use any ionizing radiation. This examination will be performed by radiologist. 5

CARDIAC STRESS TEST* The cardiac stress test gives information about the blood flow to heart muscle tissue during maximum physical exertion and helps to diagnose coronary artery disease.

The heart is stressed towards maximum physical exertion while walking on a treadmill, riding a bicycle or with intravenous pharmacological stimulation.

6 CARDIAC STRESS TEST* The cardiac stress test gives information about the blood flow to heart muscle tissue during maximum physical exertion and helps to diagnose coronary artery disease. This evaluates the heart during rest, stress and recovery using an electrocardiogram (ECG). The heart is stressed towards maximum physical exertion while walking on a treadmill, riding a bicycle or with intravenous pharmacological stimulation. A physician will examine the symptoms, blood pressure response and follow ECG waves in order to give helpful information regarding the health of the coronary arteries. ABDOMINAL ULTRASOUND* An abdominal ultrasound is performed to evaluate abdominal structures, including the liver, gallbladder, spleen, kidney, urinary tract, bladder, ovaries, uterus, prostate, lymph nodes and big vessels like abdominal aorta. This extremely safe test performed by radiologist and provides valuable information. 30 minutes. THYROID ULTRASOUND Ultrasound is very sensitive and shows many nodules that cannot be felt by doctor during the examination. That s why, Thyroid ultrasound is the most helpful way to screen and track thyroid nodules. Ultrasound uses sound waves to produce pictures that obtains valuable information about features of nodule to distinguish between benign and malignant. This safe examination will be performed by radiologist. EYE EXAMINATION Optimal vision is among the most vital of senses that impacts our daily lives. A comprehensive eye examination is important to detect early systemic effects of chronic diseases like diabetes, high blood pressure and autoimmune diseases. Key tests will include eye, as well as visual acuity and refractive errors. It is very helpful to determine, and when possible, correct myopia (near-sightedness), hyperopia (far-sightedness), and astigmatism (distortion of vision due to shape of our eyes over time). The ophthalmologist will examine the cornea, lens, retina, optic nerve, and the retinal veins and arteries. You will also discuss an individualized strategy to protect and improve your eye health. 30 minutes. 6

Tympanometry test shows middle-ear and eardrum functions to assess the sound conduction to the inner ear.

7 HEARING EVALUATION Hearing loss can be subtle over time such that many people are not aware of the impact it creates on their daily lives. At times, there are opportunities to improve the hearing loss and at other times, one can discuss the need for devices to improve hearing. Tympanometry test shows middle-ear and eardrum functions to assess the sound conduction to the inner ear. Audiometry test is performed in the sound booth using headphones and determines hearing sensitivity. This test evaluates the functions of outer, middle and inner ear system. A bone conduction study will be used to evaluate inner ear system function. Together, these tests will give a comprehensive hearing evaluation. 30 minutes. DEXA BODY COMPOSITION AND SCREENING FOR OSTEOPOROSIS This scan provides the most accurate and precise measurement of body fat, lean mass and bones. DEXA imaging tells you how much fat and lean mass you re carrying and how it s distributed in your arms, legs and trunk. Whereas many use skin calipers and bio-impedance to estimate body fat, it is important to highlight the need for precise measurement. This test will be used to determine and track your optimal body composition, determine calorie needs and to help in determining an optimal exercise program. Moreover, it will be used to measure bone mineral density for screening of osteoporosis. This comfortable test is relatively easy to perform and the amount of radiation exposure is extremely low. Optional Testing During your initial consultation, you and your Canyon Ranch doctor will discuss and recommend if optional screening tests are needed to establish your baseline health status. GYNECOLOGICAL EXAMINATION & PAP SMEAR TEST (WOMAN ONLY) Both reproductive and sexual health review are very important for women once they become sexually active. Specifically, it is recommended that a gynecological exam and PAP smear test are performed every three years up to the age of 65. Best health comes from routine screening and early detection. 7

Mammography uses low-energy x-rays and ultrasound uses sound waves.

8 MAMMOGRAM & BREAST ULTRASOUND (WOMAN ONLY) Breast cancer is the most common cancer among women. Mammography and breast ultrasound are the recommended screening tests to detect breast cancer early, especially when there are no symptoms. Mammography uses low-energy x-rays and ultrasound uses sound waves. It is increasingly recommended for both tests to be performed as part of a comprehensive evaluation of breast health every two years. COLONOSCOPY Colonoscopy is a test to look at the inner lining of large intestine. Before this test, 2 to 3 days colon preparation including liquid diet and laxatives is needed to clean out colon. Gastroenterologist uses a thin, flexible tube to look at the colon under sedation. A colonoscopy helps to find ulcers, colon polyps, tumors, and areas of inflammation or bleeding. During a colonoscopy, tissue samples can be collected and abnormal growths can be taken out. Colonoscopy is recommended for adults over 50 as a screening test to check for cancer or precancerous growths in the colon or rectum. CARDIAC CALCIUM SCORING A cardiac CT for calcium scoring is a convenient and noninvasive way of evaluating whether you may be at increased risk for a heart attack. It obtains information about the presence, location and extent of calcified plaque in the coronary arteries containing blood to the heart muscle. 15 minutes. LUNG CT SCAN Lung screening can be performed in the same session. Annual screening for lung cancer with low-dose computed tomography (LDCT) is recommended for adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. The exam takes little time, causes no pain, and does not require injection of contrast material. No radiation remains in a patient's body after a CT examination. After the CT exam, you can return to your normal daily life. 15 minutes. 8

About Canyon Ranch Medicine Since Canyon Ranch opened its doors in 1979, we have embraced an integrative approach to wellness, bringing together professionals in various disciplines to help you

Our renowned physicians are here to care for you, take the time to fully understand your current state of health, and help you live a longer, fuller life.

Wellness Environment During your Canyon Ranch stay, you will benefit from the all-healthy atmosphere.

9 About Canyon Ranch Medicine Since Canyon Ranch opened its doors in 1979, we have embraced an integrative approach to wellness, bringing together professionals in various disciplines to help you achieve your goals, create greater balance in your life and look & feel your very best. Canyon Ranch Medicine is a new paradigm of health care, best described as personalized, integrative medicine. Our renowned physicians are here to care for you, take the time to fully understand your current state of health, and help you live a longer, fuller life. Rigorously trained, open-minded practitioners and physicians draw freely on both modern science and traditional approaches. Wellness Environment During your Canyon Ranch stay, you will benefit from the all-healthy atmosphere. Kaplankaya is a natural paradise where you will enjoy the Aegean coast with its mild climate and breathtaking scenery. You will nourish yourself with delicious and healthy cuisine. You will reflect on your previous eating patterns before visiting Kaplankaya, have an immersion experience here, and then create awareness of how you will nourish yourself at home. Our team of fitness experts will connect you to the best movement plan to fit with your life and lifestyle. The best exercise is the one that we are willing to do again and again. Therefore, at Canyon Ranch, you may wish to experience new routines from different classes and activities to find exercise and movement that resonate with you physically, mentally, emotionally and spiritually. It is important to experience joy. Take time to relax in our luxurious Aquavana hydrothermal suite, which includes a Finnish sauna, steam room, experiential showers and hamam. At the end of each perfect day, reward yourself with a soothing massage or other spa treatment. Bozbük Mahallesi Merkez Sokak No: 198, Milas, Muğla, Turkey Reservations: kaplankaya@canyonranch.com 9

Table of Contents. Early Identification Chart Biometric Screening Comprehensive Cardiovascular Disease Risk Assessment...

Table of Contents. Early Identification Chart Biometric Screening Comprehensive Cardiovascular Disease Risk Assessment... Public Safety Table of Contents Early Identification Chart... 1 Biometric Screening... 2 Comprehensive Cardiovascular Disease Risk Assessment.... 2 Recommended after Comprehensive Cardiovascular Disease