Ladies. . . Next screening guideline: cervical cancer.

The American Cancer Society cervical cancer screening guidelines for this are dependent on many factors: age, risk factors, choice of screening test and screening history.  Let’s break it down by age.

21.  Women at average risk should begin screening at 21 years of age (or 3 years after first vaginal intercourse, regardless if they had the HPV vaccines).  Then yearly screening with routine pap or every other year with the liquid-based pap until age 30.  Your doctor will choose either the conventional pap or the liquid-based pap depending on preference.  As the patient you’ll notice no difference in technique–it’s just a different type of specimen for the lab (a slide or a specimen container).

30.  After 30 women who have had three consecutively normal screening paps may choose to be screened every two to three years with conventional or liquid based pap or every 3 years with HPV DNA testing and conventional or liquid based pap.  HPV testing may be done as the human papillomavirus may make the cells on the cervix more likely to change to cancer.   Many women with HPV infection will not develop changes on their cervix.  HPV infection is most common in persons who have had sexual intercourse, so new partners introduce the ability to pick up a new strain of the HPV infection.

70.  Screening can continue in women who still have their cervix until age 70.  (Women with hysterectomies most often have the cervix removed and do not need repeat paps unless the uterus was taken out due to cancer).  Paps can also be stopped if they have been normal in the previous 10 years and 3 consecutive paps have been normal.

I encourage my female patients to come in for an annual preventive health exam.   Some years this will include a pap and some not.   This is a time to review blood pressure, vaccine needs, skin-cancer screening, breast exam and the like. . .

Posted in pap test, Uncategorized, Women's Health | Tagged , , , , , , , , , , | Comments Off on Ladies. . . Next screening guideline: cervical cancer.

Cancer screening guidelines: The down-and-dirty on breast cancer screening.

flickr.com/photos/ loonyhiker/ 6819318915

The American Cancer Society updated their guidelines on cancer screening.  I’m going to update myself (and you!) with those.  This will be broken up into a few blogs.  In honor of Breast Cancer Awareness month, it’ll be reviewed first.

Breast exam.  Breast cancer screening is guided by age in the average-risk woman.  Between 20 and 39 women should have breast exam by a physician every three years and then annually at age 40.  During this exam, the provider should discuss how to perform a self-breast exam (and the potential benefits, limitations and harms associated with it).  Women should be aware and watch for breast changes.  Discuss with your physician a breast or ovarian cancer family history—most important in first- and second-degree relatives (like a mother and aunt).

Mammograms.  These should begin at 40 and continue yearly.  The benefits of mammograms are the reduction in the risk of dying from breast cancer and, if cancer is detected, less aggressive measures may be needed.  This may translate to taking out a lump of breast tissue instead of the entire breast, less aggressive adjunctive treatment and more treatment options.  Mammograms may not detect all cancers and some cancers will have devastating outcomes.  Biopsies may be performed when possibly the breast cancer would not have been fatal meaning possibly it was an unneeded procedure.  Mammography should be continued as long as the woman would be physically able to endure breast cancer treatment.  There is no upper age at which mammograms need to be discontinued.

Are you in need of a check-up?

Posted in breast, Uncategorized, Women's Health | Tagged , , , , , , , , , | Comments Off on Cancer screening guidelines: The down-and-dirty on breast cancer screening.

Want to start smoking again after a stroke?

flickr.com/ photos/lanier67/ 237055775

Patients who started smoking again after an ischemic (not-enough-blood-getting-to-the-brain) stroke raise their risk of dying by nearly threefold within one year.  The risk of dying increases the sooner the smoking relapse occurs.  Patients who start smoking within 10 days of leaving the hospital are five times more likely to die within a year compared to those who remain smoke-free.

This was a study of 921 active smokers who stopped smoking during their hospital stay after an ischemic stroke.  Their habits were followed after hospital discharge and even five cigarettes per day were linked with increased cardiovascular events (like a heart attack).

You should know that an ischemic stroke is a sign from the body that the brain is having a difficult time consistently getting blood flow.  It’s in your best interest to make it EASY for the brain (and heart and other bodily organs) to get blood.  Stop smoking for good.

Posted in Brain, General Medicine- Adults, Uncategorized | Tagged , , , , , , , , , , , , | Comments Off on Want to start smoking again after a stroke?

Does your tween have acne?

Acne in teens.  Recently,  I saw a tween for a knee injury.  Upon completion of the visit I asked him how his skin was doing.  His mom energetically piped in that his current skin condition was good for him and that she was concerned that his acne would “bloom” like his older sister.  (She had needed Accutane to control her acne.)

Acne is common and seemingly relentless.  Washing with soap and water twice daily helps keep the face clean.  Patting the face dry with a towel (instead of scrubbing) helps to not rough up the skin.    Many over the counter acne compounds contain benzoyl peroxide.  This is first-line therapy for acne.  If acne persists, then other topical agents can be used: retinoids (like Retin A) or antibiotics (erythromycin or clindamycin).  If those do not work,then antibiotics by mouth may be used.  As a last resort Accutane can be used.  Accutane has its own challenges and risks.

I encourage you to ask your doctor to help with skin care.  Being a kid is hard enough without eye-catching acne.

Posted in Dermatology, General Medicine- Adults, Pediatrics, Uncategorized | Tagged , , , , , , , , , , | Comments Off on Does your tween have acne?

HPV vaccine was studied and found NOT to increase teenage sexual activity.

This LA Times article is informative with an interesting perspective.  Please read on. . . especially if you are a” tween” parent.

http://www.latimes.com/health/boostershots/la-heb-promiscuity-hpv-vaccine-20121015,0,5783319.story

Posted in Pediatrics, Uncategorized, Vaccines, Women's Health | Tagged , , , , , , , , , | Comments Off on HPV vaccine was studied and found NOT to increase teenage sexual activity.

Fellow Wichitan, do you have a question about community water fluoridation?

A former CDC Oral health expert is in Wichita… so here is your chance to have questions answered by one of the nation’s leading water fluoridation experts.  Stop by in person or submit questions online.
WHAT: Attend a discussion lead by Bill Maas, a policy advisor to the Pew Children’s Dental Campaign and former director of the division of oral health at the CDC, to learn about water fluoridation from an expert in oral health. Questions for Maas to address during the discussion can be sent to the hash tag #FluorideICT on Twitter, posted to our Facebook page or by email to info@wichitansforhealthyteeth.org

 

WHEN:  Tuesday, Oct. 16 at 6:00 to 7:00 p.m.

 

WHERE:  Via Christi Family Medicine/Specialty Clinics – 707 N Emporia, Wichita.  Please use south entrance. Door-side parking available.

 

WHO:  Bill Maas is a policy advisor to the Pew Children’s Dental Campaign.  For 11 years, he served as director of the Division of Oral Health at the Centers for Disease Control and Prevention. From 1997 to 2001, Maas served as the chief dental officer of the U.S. Public Health Service and as an Assistant Surgeon General. Today, he is a clinical professor at the University of Maryland Dental School’s department of health promotion and policy. Maas is considering one of the nation’s leading experts on community water fluoridation.

Stay involved.  Educate yourself.

 

Posted in General Medicine- Adults, oral health, Pediatrics, Uncategorized | Tagged , , , , , , , , , , , | Comments Off on Fellow Wichitan, do you have a question about community water fluoridation?

Wound care 101

We all get wounds–which heal most of the time without problems.  Our bodies are amazing and can heal most wounds under the right conditions.

The ideal conditions are a clean, moist and friendly environment.

  • Keeping wounds “clean” does NOT mean using hydrogen peroxide, isopropyl alcohol or an antiseptic spray as these can harm proper wound healing.  Saline and mild soap is more ideal.  A moist environment is best.
  • If there is a scab on the wound, leave the scab alone.
  • Antibiotic ointment is okay to use for a short time but if used for a long period of time an allergic reaction could occur.  Petroleum jelly helps keep the surface of the wound moist and cover.  Then top it with a clean dressing (like gauze) that can absorb the moisture.

Conditions that need to be treated to heal a wound. . .

  • Infection.  See your doctor
  • Swelling.  Raise the extremity above the heart, if possible.  Use a compression wrap.

Hope this helps.

Posted in General Medicine- Adults, Uncategorized, wound care | Tagged , , , , , , , , , | Comments Off on Wound care 101

A new obesity drug approved! Read on. . .

The FDA approved an obesity drug despite concerns that it might increase the risk of heart valve problems.  This release is in response to more than 1/3 of Americans are considered obese (a BMI of at least 30).  This drug, lorcaserin hydrochloride (Belviq) is a scheduled drug meaning no more than a 30 day prescription.  Patients taking lorcaserin for up to a year had an average weight loss of 3.7%.  This drug is not allowed during pregnancy.  Side effects may include problems with thinking, confusion, sleepiness, and in higher doses, hallucinations, euphoria or dissociation.

Consider weight loss and exercise.  Side effects and risks are better.

Posted in Uncategorized | Comments Off on A new obesity drug approved! Read on. . .

Early glucose control important in prediabetes

flickr.com/photos/ funadium/ 553343932

Reach the goal of fasting blood sugar under 100!  Bringing down blood sugars as soon as possible in prediabetes provides the best shot at preventing disease progression.  This comes into play when a patient has a fasting blood sugar that is between 100 and 126.  Within this range, it shows that the patient’s body is having a hard time controlling blood sugars.   A landmark Diabetes Prevention Program study was performed which showed regardless if blood sugars were brought down by lifestyle intervention or drug therapy the importance is that blood sugars were normalized.  Even transient reversion to normal blood sugars was associated with a significantly reduced risk of diabetes.

Overall, this study showed that the strategy is unimportant as long as at the intervention is early (when someone has prediabetes) and can restore normal blood sugar, even if just transiently.   Weight loss and exercise have been shown to help keep blood sugars down.

Hope this helps.

Posted in Diabetes, General Medicine- Adults, obesity, Uncategorized | Tagged , , , , , , , , , , | Comments Off on Early glucose control important in prediabetes

Recommendations to Decrease SIDS risk

SIDS, Sudden Infant Death Syndrome, is a life-altering, grief-filled event.  There are some ways to decrease the risk.

  • Infants should be placed on their back to sleep until 12 months of age.  Side sleeping is not suggested.
  • Sleep on a firm surface, like a firm mattress covered with a fitted sheet.
  • Sharing a room with an infant, without sharing a bed, can reduce the risk of SIDS by up to 50%
  • Soft objects (loose bedding, stuffed animals, and pillows) should be kept out of the crib.
  • Pregnant women should receive prenatal care
  • Avoid smoke exposure during pregnancy and after birth.
  • Avoid alcohol and illicit drug use during pregnancy and after birth
  • Breastfeeding reduces SIDS risk.
  • Do not use home cardio respiratory monitors (like apnea monitors) as a means of reducing the risk of SIDS.
  • Offer the infant a pacifier at naptime and bedtime.
  • Avoid overheating of infants.

Hope this helps.

Posted in Pediatrics, safety, Uncategorized | Tagged , , , , , , , , , , | Comments Off on Recommendations to Decrease SIDS risk