To your health
Welcome to our inaugural Women’s Health special section, in which we asked area health care professionals to write about the issues they believe have the most impact when it comes to the fairer sex.
On the following pages, you’ll find short, to-the-point advice and information on everything from dental care during pregnancy to facts about fibroids.
Here’s to your health in 2011 in beyond!
Women and health: What’s on the short list — and what else should be?
When it comes to women’s health, what’s on your mind? According to Dr. Polly Watson, a physician at Rex Healthcare who practices at Boylan Healthcare in Raleigh, these are among the top questions patients ask her.
What does an abnormal Pap test mean?
Cervical cancer takes several years to develop, and Pap tests are effective at finding abnormal cells before they become cancer. But an abnormal result doesn’t always mean cancer. “Most abnormal results are caused by a common virus, HPV, that can clear up on its own,” she says. “Lifestyle choices, like not smoking, can help your body clear HPV too.” Your doctor likely will suggest other tests if you have an abnormal Pap result.
What’s a safe solution for hot flashes, night sweats and mood swings?
“These symptoms of menopause can be severe, and my patients are looking for safe ways to get relief,” says Watson, who has specialized training in menopause treatment. But there’s been a lot of confusion about which medicines are safe and what’s effective. “Newer hormone therapies now offer lower doses and more natural forms of hormones,” she notes.
Other ways to reduce the symptoms of menopause include paced breathing through yoga, increasing the amount of omega 3 fatty acids in your diet, and cutting back on caffeine and spicy foods.
“Some over-the-counter medicines and natural remedies might help too, but make sure your doctor knows everything you’re taking because these remedies might have side effects,” Watson cautions.
What should I do about brittle bone disease?
Osteoporosis, which causes the bones to become weaker, also is on the minds of many women, Watson says. “Many of my patients worry about losing height or breaking a bone, so they’re interested to learn about the many things they can do to protect their bones,” she notes.
For stronger bones, Watson recommends:
- Adding weight-bearing exercises
- Taking calcium and vitamin D
- Limiting alcohol to less than one drink per day
- Refraining from smoking
- Getting regular check-ups
For women with osteoporosis, new medicines can stop bone loss, and some even add bone mass.
“Every woman has different risks for osteoporosis, so your best bet is to talk to your doctor about all the things you can do to make your bones stronger and healthier,” Watson says.
Two more questions to ask
According to Watson, women also should ask their doctor about two other health issues: vaginal dryness and the human papilloma virus, or HPV.
While vaginal dryness can make women uncomfortable, particularly during sex, Watson notes that there are several effective treatments available.
“Don’t be shy,” she says. “Your doctor can work with you to find a solution.”
It’s also important to get tested for HPV and talk with your doctor about whether to get the HPV virus. Certain types of HPV can cause cervical cancer, and the HPV vaccine is approved for patients ages 9 to 26. Some studies show that it might be the best way to catch cervical cancer early.
“We can screen for HPV easily at the same time as a Pap smear,” Watson says. “So ask your doctor about both HPV testing and the vaccine.”
For more information on osteoporosis, HPV and menopause, visit www.nih.gov or www.webmd.com, or contact Rex Healthcare at (919) 784-3100 or visit www.rexhealth.com.
Why oral care is essential during pregnancy
Attention to oral health care issues is obviously important for all individuals but can be particularly critical for women during pregnancy.
Hormonal shifts occur over this nine-month span, often resulting in changes within the oral environment. It’s important for a pregnant woman to maintain optimum health so that the health of the developing child is never compromised, so regular maintenance visits to the dentist should be continued every four to six months.
Some expectant mothers have increased inflammation of the gum tissue during pregnancy, so attention to cleanliness and detail is important here as well. If dental treatment is needed that will require anesthetics or restorative care of the teeth, then a letter from the patient’s obstetrician regarding the safety and timing of the procedure must be obtained.
A toothache can cause stress on the body, and consequently stress the developing child. For this reason, it’s essential to remedy the problem at hand so that everyone remains healthy and free from duress.
Remember that the maintenance of good oral health for mom is directly related to baby’s health.
C. Ashley Mann DDS is a dentist based in Cary. To learn more, call (919) 462-9338 or visit www.drashleymann.com.
The FITT principle
If you’re going to spend time and energy getting your body into the best shape of your life, then you deserve to get the maximum results for your efforts. Whether you’re just starting out or are an exercise veteran looking to amp up your routine, think of the FITT Principle (frequency, intensity, type and time) as a set of rules to achieve results with your cardio-respiratory and resistance-training programs.
Frequency. Following any form of exercise, the body goes through a process to repair and replenish the energy used during a workout. The frequency of exercise must be balanced to provide enough stress on the body while also allowing enough time to rest so that the body can repair itself. The National Academy of Sports Medicine (NASM) guidelines for cardiovascular training recommend a minimum of three sessions per week and a maximum of five to six sessions. The frequency of resistance training varies based upon the individual and program format. Programs that train each body part at each session can be performed three to four days a week, while programs that focus on one to two major body parts can be performed up to six days per week.
Intensity. It’s important to have a balance between exercising intensely and overloading the body. Experts recommend using your target heart rate zones during cardiovascular sessions. Beginners can start by using 50 to 70 percent of their target zones, while more advanced exercisers should do so at between 70 and 85 percent. Target zones can be found by first subtracting your current age from 220, then multiplying the target percentage. For resistance training, the amount of weight lifted, number of repetitions performed, and length of rest or time of an exercise session should be considered. Try changing one or more of these three areas. For example, increase the amount of weight while decreasing repetitions, decrease the amount of weight while increasing repetitions or decrease the amount of rest time between sets.
Type. For cardiovascular training, choose exercises that are continuous in nature and that use large muscle groups. Try running, swimming, cycling, aerobics classes or circuit training. And add other types of resistance training to your program, like resistance bands, circuit training, or body weight exercises with a Bosu or stability ball.
Time. Individuals with low fitness levels should aim to start with 20- to 30-minute cardiovascular sessions. This can increase to 45 to 60 minutes per session as fitness levels improve. The average recommendation time for a resistance training program is between 45 and 60 minutes.
Following these guidelines can help you succeed in achieving your goals for any fitness program. Remember to change one or more of these principles occasionally to prevent plateaus, and continue to challenge your workouts and improve your fitness level. Also remember to rest. Exercising too frequently or too intensely slows down your body’s ability to recover. The harder you exercise, the more time you need to rest.
Nicki Wilson is a master-level personal trainer with O2 Fitness, which has locations throughout the Triangle. To learn more, visit www.o2fitnessclubs.com.
Women and heart health: What you should know
Many women are unaware that heart disease is a more significant health threat to them than breast cancer. Educating women on their risk factors and ways to make lifestyle modifications can help reduce the risk of developing cardiovascular disease.
Unfortunately, there are some risk factors that cannot be modified, including age and a family history of premature cardiac disease. But there are some factors you can change, including:
- Smoking. Women who smoke have a higher death risk from cardiovascular disease.
- High blood pressure. Lifestyle modifications like eating a low-salt diet and getting exercise can keep blood pressure in a normal range.
- High cholesterol and triglycerides. Women should get regular cholesterol screenings and maintain a low-fat, low-cholesterol diet.
- Lack of exercise. Studies have found that a sedentary lifestyle is a major risk factor for coronary heart disease. As little as two-and-a-half hours of moderate activity per week can help reduce this risk.
- Excess pounds/poor diet. Women should consume plenty of fruits and vegetables, fiber-rich foods, and cereals low in saturated and trans fats. The risk for heart disease is particularly high in women who have excess abdominal fat.
- Diabetes. Diabetic women have a risk that’s five to seven times higher than nondiabetic women for cardiovascular disease.
- Stress. Women should adopt healthy ways of dealing with stress, like taking breaks from work and home duties, reading books, and taking daily walks.
Depression and isolation also are risk factors for women. It’s important to talk with a health care professional about these risks in order to take lifesaving preventive measures.
Dr. Paula Miller is part of UNC Health Care’s Women’s Heart Program. To learn more about reducing your risk for cardiovascular disease, call toll-free (866) 862-4327 or visit www.uncheartandvascular.org.
Tips for a healthy recovery from plastic surgery
The recovery process following plastic surgery differs from patient to patient, particularly when it comes to the type and number of procedures performed.
Surgery aside, it’s important to consider the physical and emotional issues that can occur during recovery. As your surgeon will tell you, it’s essential not to rush the recovery process. Allowing your body to heal properly will lead to more rewarding results.
Here are some tips for a healthy, satisfying recovery.
- Be prepared. Fill prescriptions ahead of time, prepare ice packs to help reduce swelling and review pre-operative instructions to make sure you understand them.
- Plan recovery time. A full recovery can range from a few days to a few weeks. Keep in mind how surgery will affect your job and personal obligations.
- Be realistic. Almost all cosmetic surgery procedures involve bruising and swelling. Full results won’t reveal themselves for a few weeks or longer, so don’t worry. Let the natural healing process take place.
- Follow instructions. Whether it’s taking prescribed medication or wearing a compression garment, your surgeon can provide the best advice for a quick, safe recovery.
- Elevate. If you’ve had surgery to the head or upper body such as a breast augmentation or eyelid surgery, then keep the area elevated for several days. Doing so will help reduce swelling and can increase the recovery process without compromising results.
- Consult. Ask your physician before taking aspirin or anti-inflammatory medications, which can interfere with prescriptions given by your surgeon. Also check which over-the-counter and prescription medicines you should avoid during recovery.
- Stop smoking. If you smoke, then stop for at least six weeks prior to surgery and anticipate not smoking during the recovery process. Smoking greatly increases the risk for complications.
- Stay on track. Be sure to attend all post-operative appointments.
Dr. Glenn M. Davis is board certified by the American Board of Plastic Surgery. To learn more, call (919) 785-1120 or visit www.drgmdavis.com.
Facts about fibroids
You might have one or several without realizing it. Uterine fibroids, growths inside the uterus, are clinically present in as many as one out of four women throughout their lifetime.
While women who have fibroids do not have an increased risk of developing uterine cancer, the fact that they’re the primary reason for hysterectomies indicates that associated symptoms can be disruptive and uncomfortable.
Most common during a woman’s reproductive years, uterine fibroids develop from uterine tissue and can be small or large. They typically do not cause problems or require treatment, though troublesome fibroids can be treated medically or surgically depending upon their location, size, and severity of symptoms.
In women who do experience symptoms, the most common ones include heavy menstrual bleeding, periods lasting seven or more days, abdominal pain or pressure, frequent or difficulty with urination, constipation, and back pain or pressure.
A doctor often finds a fibroid during a routine pelvic exam. An ultrasound, a painless exam that uses sound waves to create an image of the uterus, can confirm the presence, type, location and size of a fibroid.
Fibroids typically grow slowly and can even shrink after menopause. They also rarely interfere with pregnancy. With this in mind, no treatment is necessary when no symptoms are present.
If symptoms do appear, they can be uncomfortable and can interfere with day-to-day activities and even lead to anemia. Fortunately, treatments like hormone therapy are available, as are surgical treatments like a hysterectomy, myomectomy, endometrial ablation, uterine artery embolization, and MRI-guided ultrasound surgery.
If you have troublesome fibroid symptoms, then help is available. Work with your doctor to determine the appropriate treatment for you.
Dr. Marili Witt is a specialist with Wake Specialty Physicians — Women’s Center in Raleigh. To learn more, call (919) 350-1380.
A new diagnostic tool for women
Women who need a breast biopsy now have an option other than surgery. After having a stereotactic biopsy — a minimally invasive procedure that take about two hours — patients can leave with just a Band-Aid and can drive themselves home.
Smithfield resident Hazel Whitehurst, 88, admits that she was afraid when her doctor first scheduled the biopsy for her last year.
“I figured that there would be cutting, but there was one little nick where the radiologist inserted the instrument,” she says. “I didn’t have pain.”
To perform this type of biopsy, a radiographer first takes X-rays at different angles so that the surgeon or radiologist can see a three-dimensional image of the lesion. A computer then analyzes the images and gives a needle-guidance system the exact coordinates of the mass.
The patient sits in a chair throughout the imaging and biopsy, in which the breast is compressed and the skin is numbed before a small, quarter-inch cut is made. A hollow probe then is inserted into the incision and then into the suspicious area. Using vacuum pressure, the probe pulls the tissue through the needle and into a chamber. The needle is removed, and pressure is applied to stop any bleeding.
An added benefit is that patients can get results more quickly. Smithfield resident Rena Allen, 76, had a biopsy on a recent Tuesday afternoon. By Thursday morning, her doctor’s office had called with good news that her tissue sample was benign.
“You don’t know what a burden was lifted,” she says. “It was like someone had taken a brick off of my shoulders.”
While women can develop breast cancer at any age, it’s most likely to occur after age 40, according to the American Cancer Society. And the chance increases as women get older.
The good news: Only two to four mammograms out of every 1,000 lead to a cancer diagnosis, one of every 10 women requiring a follow-up or diagnostic mammogram will need a biopsy, and 80 percent of those biopsies will be benign.
To learn more about stereotactic biopsies, which are performed by Drs. Dennis Koffer and James B. Collins III at the Ambulatory Imaging Center inside the Johnston Medical Mall in Smithfield, call (919) 934-8171 or visit www.johnstonhealth.org.
Why wearing a mouth guard can save your child’s life
If you’re like me and have a child who participates in a competitive sport, then he or she should be wearing an athletic mouth guard.
Unfortunately, many parents and coaches don’t fully understand the reasons behind wearing this essential piece of safety equipment. And while most understand that the guard functions to protect against tooth injury, some perceive that wearing one is uncomfortable or gets in the way of speech. But it actually might save your child’s life.
According to the American Academy of Pediatrics, the number of sports-related concussions is highest in high school-aged athletes, but the number in younger athletes is significant and on the rise as well, particularly in football and hockey. And younger athletes are more susceptible to the effects of a concussion because their brains are still developing.
A concussion occurs when there’s a sudden blow to the head or body that causes the brain to shake inside the skull, temporarily preventing it from working normally. Side effects can range from changes in the ability to think and concentrate to headaches and dizziness to long-term personality changes and depression.
A custom-fitted athletic mouth guard can help decrease the odds of getting a concussion by helping to absorb the force of a blow to the jaw and helping to stabilize the head and strengthen the neck. On the market, there are custom-fitted, mouth-formed and over-the-counter varieties, the last of which is held in only by clenching and is the least protective and comfortable.
The Academy for Sports Dentistry recommends the use of a properly fitted mouth guard, which encourages the use of a custom-fabricated guard made over a dental cast and delivered under the supervision of a dentist. For this reason, dental professionals should play an active role in educating parents and coaches on this important, potentially lifesaving device.
Dr. Valerie M. Preston is owner of 614 Dental Spa in Raleigh. To learn more, call (919) 518-0540 or visit www.614dentalspa.com.