Year: 2015

Stop and think back to when you were a child. You will likely remember this as a time where you felt invincible, fearless, strong and able-bodied. You could do anything, be anyone, and get away with eating and drinking just about anything without worry. Are there health consequences to this fancy-free period of life?  There is disease I wish to call to your attention. It preys on children and will not appear until their later years. It most often comes without warning and usually in one quick SNAP! I am talking about your bones.

By the year 2020, over half of Americans will be diagnosed with weak or diseased bones, referred to as Osteopenia and Osteoporosis respectively. Osteoporosis leads to more than 2 million bone fractures per year in the United States. The most common bone fractures are those of the spine, hip and wrist. If you are elderly and fall and break a hip, you are at risk of dying within 3 months because of this fall. This is not only painful physically, but emotionally and financially. Medical care for fractures results in Americans incurring more than 18 billion per year in health care dollars, add losing time from work and the cost is greater. The startling fact is that this isn’t something that just happens; it is a process that evolves overtime dating back to your childhood. For most people it is preventable, and it cannot be stressed enough that prevention starts in childhood. It is imperative we teach our children about their health, and certainly their bones. We must be their role models, creating an awareness and healthy lifestyle that involves and protects the entire family.

Think back to that life-sized skeleton you had in Science class. How can such a dense, solid structure be so vulnerable? Bone is a living organ in our body, it provides us with our form and function, and protects our brain, heart and lungs. Just like the heart must beat to work, bone requires daily remodeling of its framework to remain resilient and strong. If it does not have the vital nutrients it needs for continuous maintenance, then the framework is compromised and weakened. This weakness is much like a brick wall that loses its mortar overtime if left unattended.

You may now be thinking how do I know if I’m at risk? What can I do to prevent this? Am I too late? The good thing is that bone is forgiving and the time to act is now. We can identify those at risk for bone disease. We know that women are five times more likely to develop osteoporosis; however more men are likely to die from this disease. The following factors cause or contribute to osteoporosis and bone fractures:

• You are over age 50
• Family history of osteoporosis or a bone fracture
• Onset of menopause before age 45 or having ovaries removed before age 50
• Breast cancer survivor after radiation and chemotherapy
• Certain medications such as steroids, seizure or thyroid medications
• Diseases of the thyroid and kidney, inflammatory bowel disease, rheumatoid arthritis, and lupus
• Low calcium intake
• Vitamin D insufficiency
• Excess vitamin A
• High caffeine or salt intake
• Aluminum (in antacids)
• Alcohol (three or more drinks per day)
• Inadequate physical activity or being immobile
• Smoking (self or loved one who smokes around you)
• Falling
• Being thin or petite
• Poor vision, even with glasses.

If you identify with any of these risk factors, talk with your health care provider. Take steps to stop this preventable illness. It’s never too late to start healthy habits through an active lifestyle, balanced diet rich in calcium and vitamin D and seeking treatment if you are at risk.  If you’re 65 or older, or have risk factors for bone disease at a younger age, there is a simple, non-invasive test. It is called a DEXA scan that assesses your current state of bone health. It takes less than 15 minutes and can be done when you fully dressed. Beyond assessing your bones directly, you can even be tested for nutritional or medical illnesses affecting your bones.  No matter your age, gender or ethnicity, take the time to stop this preventable illness. Talk to your health care provider and go online. The National Institute of Health and the National Osteoporosis Foundation are great places to start and seek reliable information.

Reference:  American College of Obstetrician Gynecologist at www.acog.org, National Institute of Health and the National Osteoporosis Foundation

Have you heard about the current debate over breast cancer screening?  It’s a heated topic. We are all at risk for breast cancer, even our male counterparts. Our risks increase with our age. Well, ladies, age is the current debate. What age is best to start breast cancer screening if you have no family history or risk factors?

Let’s look closely at this debate, which has come about because of new recommendations by the U.S. Preventive Services Task Force. This task force is recommending that a woman start her routine breast cancer screening NOT at age 40, but 10 years later — at age 50. To be clear, this is if you have no family history of breast cancer or risk factors like dense breasts, history of chest radiation or other medical concerns. The recommendation also states that mammogram screenings not be done annually but every two years, unless medically indicated otherwise.

You may be feeling a mix of emotions at this thought, especially if you have had breast cancer, know someone who has or if it’s in your family history.

You may be thinking, who are they and how are they suggesting this bold change? The USPSTF was created in 1984 as an independent panel of national medical experts who volunteer to review current health-care practices and then compare this to our evolving knowledge of evidence-based medicine. Based on this review, this panel then makes recommendations that aim to improve the health of all Americans through screening, counseling or primary care medical services offered. The U.S. Congress has authorized this panel to convene annually to present any needed recommendations to affect change to improve our health-care practices.

The panel believes that the practice of performing mammograms prior to age 50 in the general population does not warrant the risks to women of a younger age. Again, this means a woman without a family history or medical history placing her at risk for breast cancer. The most common harm of a mammogram prior to age 50 is a false or inaccurate reading, which results in additional unnecessary tests and procedures.

This is a major cost to our health-care system, as well. For instance, if a 40-year-old woman is told her mammogram shows possible tumors, she then goes on to have more imaging and, ultimately, a breast biopsy. If the biopsy shows normal breast tissue, the initial mammogram was therefore wrong. Could this biopsy have been avoided? Did this biopsy cause harm? Does this cause unnecessary anxiety or added discomfort to a woman? What are the overall costs to society? Bottom line, is it all worth it?  This is the argument.

I can tell you, there is a great divide in medical opinion about how and when breast cancer screening should be done in the United States. As an obstetrician gynecologist, our national organization, The American College of Obstetrician Gynecologists, has held firm that we believe it is best to start breast cancer screening at age 40 for ALL women. We also feel it is a personal decision and should be discussed with your health-care provider.

I feel strongly that the present debate might place our personal choices, access to screening and medical coverage in jeopardy over such divided opinions. It’s important that we remain a knowledgeable and active voice in this debate.

Let me show you some of the evidence for breast cancer that we know at present. Unless you have a family history of breast cancer, we all have a 1 in 8 risk of developing breast cancer in our lifetime. Think of you and seven of your girlfriends. One of you will develop breast cancer in your lifetime. If you have a family history, the chances are even higher. To make this even more real to you, let’s look at the evidence.

The lifetime risk of breast cancer by age is as follows:

• In her 20s, one woman in 1,760 has a chance of breast cancer.
• In her 30s, one woman in 220 has a chance of breast cancer.
• In her 40s, one woman in 69 has a chance of breast cancer.
• In her 50s, one woman in 42 has a chance of breast cancer.
• In her 60s, one woman in 29 has a chance of breast cancer.

Do you see how time is of essence when it comes to this cancer? It’s important to discuss and consider this debate, not just from a personal perspective but to help educate and advocate for all women. Breast cancer screening is proven to play an important role in diagnosing breast cancer early, and therefore improving a woman’s chances for survival through early treatment and ultimately a cure. The pain of losing a loved one from a completely detectable and survivable cancer cannot be described.

You have the power to be a part of this ongoing debate and the time is now. One would think it is only logical to find breast cancer fast and find it early, right? Well, unfortunately with this and really any cancer screening, it is not so simple. It is a matter of evidence-based medicine, meaning we track hard evidence about current medical practices and patient outcomes. This information is then used to apply a recommendation or practice which is best for the entire population. It is not just a matter of medicine, sadly, but of access, effectiveness, cost and certainly insurance coverage.  The guidelines for insurance coverage follow recommendations created by our national organizations and governmental guidelines.

You may become involved by contacting your local government representative. The U.S. Preventive Services Task Force has invited you to voice your opinion by going to their website, www.screeningforbreastcancer.org

Let’s talk about a serious issue that I bring up to Patients on a daily basis.  It is domestic and intimate partner violence.  What do these words mean to you?  It is a matter that I feel is important and essential to knowing you as Patient to best take care of you.  The fact is, you don’t know if someone is being abused if don’t ask.  If one is a victim, it is hard for her to bring it up herself.  By asking, it is a means to let you know that your Health care provider’s office is a safe place to start.  Domestic and intimate partner violence occurs when someone threatens or controls you, physically, emotionally or financially.  It can be an intimate partner or friend, or even a family member.   It occurs without regard to a woman’s rights, feelings, body and health.

Have you or do you know someone who has been abused or is being abused?  How do you know for sure?

Continue reading “Domestic & Intimate Partner Violence are Serious Issues”

If you had to turn in your health homework, what grade would you expect?  Did you get an “A” for effort, or did you earn a solid “C,” so think about it.  How well do you attend to your own health and wellness?  Do you take the time to get your physical and go to the dentist?  If so, were you told you needed to change your habits or seek necessary screenings like a colonoscopy?  Do you eat a balanced diet, exercise regularly and sleep well?  The bottom line, do you feel your best?  I challenge you no matter the grade you would expect to receive this year, how will you change your study habits to score better?  You see, there is already daily ongoing research being done about your health and Society as a whole.  Did you know an actual report card is published on the Internet about us?  It is a measure not only of our longevity, but our form and function as well.  This information is used to know where we are and where we need to go to reach our best state of health across all people.

Thanks to the Center for Women’s Health Research at UNC, we have a report of the current state of health of North Carolina Women.  This information is used to compare us to goals that are set nationally to ready Health People 2020 goals.  Information of all females over age 18 is reported. You may be thinking, what are they looking at?  How are we graded?

Continue reading “How do you score on your health report card?”

I speak about lifestyle and heart healthy habits on a daily basis when seeing women in my Practice.    I am looking out for the #1 killer that sieges the lives of American women each year.  Can you guess?  Heart disease.  Now is the time to remind us women to be hearty healthy.  You may see women wearing lots of red during the month of February, so break out your red wardrobe and wear it proudly to raise awareness.

We all heard about the ways to live a healthy life, but have we ever learned to how to actually do it?  The culture and lifestyle of an American is fast…fast-paced, fast-food and we certainly are very spoiled in this nation to have most everything at our fingertips…even the remote!  Our lifestyle however has trade-offs and one unfortunate trade-off is our health.  A life without activity, wholesome food and rest leads to obesity, a weakened heart and body and feeling as if you could easily fall flat out.  We do not have to accept this as Americans….Heart disease is a PREVENTABLE killer, but we have to make a mindful effort to stop it in its tracks.
Continue reading “February, the perfect time to be near and dear to your heart!”