These can be explained by the fact that you're a heavy smoker. Another factor that could contribute to these symptoms is possible anemia - you could do a complete blood count to check if you're anemic, though your hematocrit (indicator of red blood cells) may be falsely elevated because of smoking.
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Annual Checkup
It is recommended that all individuals see a Family Doctor for a full medical examination annually. Adults should get their blood pressure checked (US Preventive Task Force), a flu vaccine (CDC) and more each year.
The American Dental Association recommends dental cleanings for adults at least twice annually. Some stains can only be removed by a professional cleaning.
It’s recommended by the American Academy of Ophthalmology that every adult between the ages of 18 and 80 does an eye examination at least once every two years.
It's recommended by the American Cancer Association that every adult between the age of 20 and 80 does an annual skin screening by a licensed dermatologist.
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