HAPPY NEW YEAR!
Join us in our FB private group WhoIsTakingCAreofYou or on IG where we cover one of these topics on a weekly basis.
May we grow together!
Join us in our FB private group WhoIsTakingCAreofYou or on IG where we cover one of these topics on a weekly basis.
May we grow together!
Indeed, the Guttmacher Institute estimates that the average person who wants two children will have to think about preventing pregnancy for approximately three-quarters of their reproductive life.
For me, that process lasted 30 years.
I am an obstetrician and gynecologist. I believe that people should have the freedom to decide for themselves whether they will become parents. If they elect to expand their family, they should be able to decide whether they will carry a pregnancy, adopt or use a surrogate. They should be able to decide how many children they will have and parent them based on their personal values. They should have the freedom to use their contraceptive method of choice.
The decisions my husband and I faced were similar to those many of my patients faced. I experienced many complications during my five pregnancies despite having health insurance, access to care from well-trained physicians, a good job and excellent health. My five pregnancies resulted in three children.
One of my pregnancies involved twins in which each fetus was in their own sac but they were sharing one placenta. Starting at 16 weeks, it became evident that one twin was getting the majority of the nutrients and growing as expected while the other was struggling. As the pregnancy proceeded, my husband and I had many difficult conversations with our doctor about our options. One option was to end the life of the struggling fetus so the other one had the best chance to live. The other option was to let nature take its course. In the end, both died unexpectantly at 22 weeks.
In addition to navigating these issues for the past few decades as a patient and a mother, I have also counseled many individuals as they traveled their own journey through pregnancy and parenthood.
My last pregnancy was complicated by preterm labor that began at 19 weeks. Again, we had many conversations with our doctor as my pregnancy progressed from one with a previable fetus to a viable preterm fetus to a term fetus. There were many options to consider along the way including terminating the pregnancy. My doctor answered all of our questions with no reservations as we developed my healthcare plan week by week.
These pregancies occurred in the 1990s. Looking back, I am grateful that I had access to some of the best doctors in the country. I am grateful that my doctors did not have to consult with their lawyers or adjust their recommendations to comply with non-medical deadlines or policies mandated by politicians.
Of course, many women face these same complications and decisions today.
What’s different is the increasing likelihood that these healthcare decisions will be shaped by politics, not patients and their healthcare providers. My own experience as a mother, as well as a doctor, is that doctor-patient conversations must allow both parties to express their thoughts and knowledge. Neither a patient nor a doctor should have to worry about being investigated, fined or imprisoned for seeking or providing the care the patient needs.
Unfortunately, the ability of doctors and their pregnant patients to discuss, develop and implement healthcare plans without restriction by the government is now at risk in many states. As all of us participate in this year’s elections, I hope you will keep in mind the importance of protecting the ability of doctors to provide and patients to receive the care they need – without government intrusion.
Setting arbitrary limits on certain procedures or criminalizing physicians who provide care to you, your wife, partner, daughter, sister, daughter-in-laws or other loved ones will directly impact your own health and the health of your loved ones.
Put more simply, this year, the future of your healthcare and that of the people you care most about is on the ballot. Every vote counts.
I was speaking to someone who was about to head to her first screening mammogram. I had forgotten how nervous you can be. As we chatted, I realized that we, as medical professionals, often forget to stress how to prepare for this study.
Here are my screening mammogram pearls in order to get the best images of your breasts:
Your facility may have a radiologist speak to you the same day but most of the time, you will receive the mammogram report at a later date. The technician cannot give you any information about what they see on their screens. Do not yell at them or argue with them about this. You will be able to review your results via your patient portal in 1-2 days or you will receive a report in a few days in the mail. Do not assume that ‘no news is good news’. You need to see the official report.
If it is negative, they will tell you when to come back for your next screening. Review the report and make sure you understand everything about what it says. If there are any areas that needs to be looked at closer, you will be asked to come back for additional views. This could be a diagnostic mammogram, a breast ultrasound or a breast MRI. This will depend on what they see and your community’s resources. If you are in doubt about how to prepare for the next imaging study, call and speak to someone about what to expect.
These are just a few pearls that may reduce your anxiety and will ensure that you have the best quality images. Send me an email if you would like for me to expand on any of this information.
Did you overindulge this weekend? What is on your schedule this next week? The timeline between Thanksgiving and New Year’s weekend is the time of year during which most people will gain weight due to letting their guard down. The temptation of holiday treats and drinks make it easy to put on weight during the holiday season.
Look ahead and see what kind of activities are on your schedule for the rest of the holiday season. Factor in everything; work parties, neighborhood pot-lucks, church gatherings, family gatherings and every event you are invited to. What can you do to maintain your weight during this season?
Plan your meals
Pack your lunch
Don’t arrive at a holiday function with an empty stomach.
Sample a treat without eating all of it.
No snacking in between meals or after dinner.
As you see, you can enjoy gathering with family and friends but you need to plan your meals, drinks and activities. You can sample holiday treats without eating the whole thing. These ideas are only addressing the things you will eat and drink but coupled with monitoring your activity level, you should be able to at least maintain your weight.
It is that time of the year where we focus on your breasts! I was thinking about the topic on my walk this morning when I noticed these two pairs of acorns that literally just looked like breasts to me. It was a sign!
Are you over the age of 40 or have a first degree relative (mom, dad, sisters/brothers) that has a history of breast cancer? There is no clear consensus for when women with average risk should begin screening for breast cancer but most will say that you should begin between the ages of 40-49. See the Breast Cancer Screening Guidelines under our Resources Tab. There are several risk factors that may move the start age up. This is a conversation you should be having with your primary care clinician or ob/gyn so that you two can review your family history and other risk factors.
Breast cancer accounts for 30% of the new cancer diagnosis each year but due to improved technology and treatment, we now have a 90% 5-year survival rate.
Screening mammograms are done when there is no current problem. Diagnostic mammograms are done when there is a question about something they see on the screening mammogram and they are doing a more detailed look at the problem area.
As an ObGyn, I follow ACOG’s recommendations but you may be seeing a family medicine clinician who is following the USPTF (first column) guidelines. Once you discuss your risk factors, you can decide at what age you need to begin getting them, how often or when to stop them. You can decide if you want to get genetic testing done.
Educate yourself and ask family members if they have had breast disease. Review the Breast Cancer Screening Guidelines. Make an appointment with your clinician so that you can review your options if you think you are at high risk. Speak up for yourself if you do not agree with your clinician’s advice. My feisty mom was told that she didn’t need one since she was over 70. She told them she didn’t care and would pay for it out of pocket. You guessed it. It showed a small change which was diagnosed as a Stage I breast cancer.
Your insurance company may have guidelines on what they will pay for but you can always agree to pay for one out of pocket if you want to. If you do not have insurance, call the American Cancer Society at 1-800-227-2345 and they can direct you to the nearest place that can assist you.
Vaccine or no vaccine? Masks or no masks? Become a hermit or figure out how to live with it? Did you know that YOU, and only YOU, are responsible for your health? Act like the adult that you are and take responsibility for your health.
We just had a holiday weekend and there were so many decisions to make, weren’t there? Cake or no cake? Exercise or sit on your butt again? Smoking/vaping or kicking the habit? Alcohol–to use or abstain from? Fried chicken or grilled chicken? Pecan pie or fresh fruit? Meat or no meat? Hot dogs or lean meats? Grilled veggies or fried battered veggies? I mean, who doesn’t like fried pickles?
I could go on and on and on but I am ready to throw down the gauntlet.
It is truly your body, your decision. Not just about the vaccine or the mask. You are literally responsible for your own health so begin acting like it. I don’t care what the topic of the day is but if you are serious about avoiding hospitalization for any reason, you need to begin taking better care of yourself.
There are some people who are doing an amazing job on all fronts when it comes to their health journey. I tip my hat off to you as you have made your health a priority and I know that this takes a dedicated focus on a daily basis.
The majority of us are somewhere on the continuum of this work. I know that many of you have made so much progress and I will continue to be a pest in case you need a nudge. There are some who don’t want to proactive but then want everything done when they finally go in for care. What are you waiting for?
According to the CDC, the medical conditions that are most likely going to put you at risk of severe illness from COVID are the following:
Are any of these on your list of medical conditions? The more conditions that you have, the more at risk you will be for hospitalization, with or without COVID. Don’t wait until it is too late to take responsibility for your health. Reach out to your primary care provider and make an appointment.
We are 19 months into this pandemic so if you haven’t’ begun working on improving your numbers, losing weight or kicking the tobacco/vaping habit, you need to make an action plan.
Who was basking in the sun this weekend?
Who has basked in the sun over the last 5 or 6 decades?
Who has covered themselves with baby oil and then fallen asleep poolside, in your lounge chair in your backyard or on the beach?
Most of us probably still have our hands raised so I have 3 myths to dispel about skin cancer while I have your attention.
Myth #1: I have ‘brown’ skin so I won’t get skin cancer.
Myth #2: Only people with blue or light colored eyes get skin cancer.
Myth #3: Only older individuals will get skin cancer.
There are many types of skin cancers so it is important to read about the different types so that you can act on any changes that you may notice on your skin. The Mayo Clinic has a great summary of what to look for and the different types of skin cancers. It has great pictures of the different types of skin cancer.
Read through this resource and then look at your skin from all angles and make note of any concerns that you may have. Take pictures for your personal files. Schedule a follow up appointment with your clinician to discuss your concerns or bring this up at your next preventative visit.
This is the beginning of Holy Week for many of you so I want you to take a few minutes this evening or tomorrow to map out what you need to get done. By taking a hard look at your traditional Holy Week and Easter activities, you can decide what is most important for you to do this week. By analyzing what is most important to you is necessary to destress during Holy Week.
We want to continue to work on protecting our ‘me time’, practicing self care while ensuring that last minute spending doesn’t wreck our budget for the week.
One of the financial goals for many of you this year is to preplan your activities and trips so that you can anticipate what it will cost you. This allows you to save your money for these items that occur every year so that you don’t end up in debt creating the perfect celebration so Easter week is a great time to practice this new habit.
Preplanning allows you to decide how much you truly want to do this week. Your schedule for the week allows you to write down your menus, church schedules, and Easter activities. Once you decide on your activities, develop your budget. Shopping lists are a must so that you can minimize your trips to the store in order to decrease your impulse purchases.
Now that you have mapped out your activities, are you over scheduling yourself? Are you building in ‘me time’? Are you going to be able to truly enjoy yourself? Are you spending the weekend with other adults? If so, this is a great time to map out the chore list so that everyone is helping with each activity. Working with others ensures that everyone can spend time reflecting on what is truly important.
It is better to back off on commitments now rather than trying to decompress afterwards.
I had to take a picture of the situation I found myself in last night. I was all excited about getting Dr. Fung’s book The Obesity Code and was settling in to begin reading it. I wanted a sweet snack and was about 3 bites in when I realized that I was my own worst enemy!
Ughhhhh! I looked into what was left in the container, freezer burn and all and thought, you cannot eat bad ice cream while reading about why you are struggling with your weight! Especially when it is a flavor that you are not crazy about.
OK, you shouldn’t eat good ice cream either while reading this book but this was such a perfect example of mindless eating. I have worked to eliminate added sugars in my diet and this just creeped in. I told myself not to do it and then talked myself into 5 spoonfuls. It is such a mind game.
I put the ice cream container away and reminded myself about how I eliminated added sugars to begin with. Food is the fuel my body needs and I work to ensure that I am eating healthy and nutritious foods the majority of the time.
Here are 6 tips to combat mindless eating:
Being intentional with our foods and remembering that they are a fuel should help keep us on course.
Are you apple or pear shaped? The way your body stores fat can increase your risk for heart disease. Did you know that your body shape can be a risk factor for heart disease?
Are you shaped like an apple or a pear?
If you tend to carry your excess weight in your central or belly area, then you are apple shaped. If you tend to carry your excess weight in your hips, thighs and bottom, then you are pear shaped.
Why is this important?
Women who are apple shaped are more at risk for metabolic syndrome. This may put you at risk for heart disease, high cholesterol levels, diabetes and irregular periods.
Scientifically there are two ways:
So your heart health assessment for today is this:
Determine your body shape and tell us what your body shape is.