January is Cervical Cancer Awareness Month!

 In general, great strides have been made in the prevention of cervical cancer. We more commonly vaccinate early against strains of HPV, which are the primary cause of cervical cancer. In addition, routine screening has become better at detecting abnormalities before they can develop into cancer. This makes it even more important for women to get routine exams, not just to prevent cervical cancer, but to make sure all of their gynecological systems are healthy.

According to the CDC, while HPV is the largest determinant, other factors such as smoking, having HIV, having multiple sexual partners and having taken birth control for 5 or more years can increase your risk of developing cervical cancer. You can lower this risk by getting the HPV vaccine, not smoking and practicing safe sex. Limiting your number of lifetime sexual partners also reduces the risk of acquiring HPV and HIV.

Starting the year off with cervical cancer awareness month is a great way to remind women make their gynecological appointments if they are due for one. Patients should write down any changes or concerns before visiting their doctor to make sure nothing is forgotten during the appointment.  In addition, doctors should encourage patients to voice possible issues, and give them time to think about any abnormalities they may have not mentioned initially. It is important to rule out cervical cancer if the symptoms are there, and make sure that patients is follow-up after testing. While it can be scary, early detection and dedicated follow up can mean the difference between life and death. We have already proven that cervical cancer can be beaten, and it is important to instill that mindset into every patient it effects. 

 More Information:

Introduction to Cervical Cancer

Basic Information (Signs, Symptoms, Screening and more) 

Cervical Cancer Information - American Cancer Society 

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WHEP What's Happening!

Journal Club January:
Looking for an interesting read? This week's journal club brought us three articles from our fourth year pathway and elective students, along with great discussion. The following are the topics presented by our students. Enjoy, and tell us what you think!


Physical Domestic Violence and Subsequent Contraceptive Adoption Among Women in Rural India 
By: Rob Stephenson, MSc, PhD and colleagues

Efficacy and Safety of Tenofovir Disoproxil Fumarate in Pregnancy for the Prevention of Vertical Transmission of HBV Infection 
By: Mustafa Kemal Celen and colleagues

Implementation and Evaluation of a Training Program for the Management of Sexual Assault in the Emergency Department
By Steven A. McLaughlin, MD and colleagues

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Abuse Waiting on the Internet For Women

A recent article "Why Women Aren't Welcome on the Internet" has been catching the attention of many since it was published a week ago. In the article, the author speaks openly about her personal experiences and those of other women who have a prominent voice on the internet. Far too often and at a much higher rate than men, women of all ages face abusive language via the internet. And while rude behavior and language on the internet is nothing new, there are many extreme cases of death, rape and injury threats coupled with cyber stalking behaviors that some women must face everyday. And as cyber crimes are still fairly new, it is not often that those who threaten face repercussions for their actions.

While these actions can effect anyone with an internet connection, the hatred is disproportionately aimed at women. Girls are more likely to be cyber bullied than boys, and the article points out the studies have found that female online identities are more likely to be the target of hateful language. While a large majority of the time threats are without real credibility and lack actual threat, the author explains that there are still negative repercussions for the victims. Being persistently attacked in both public (Facebook, twitter) and private (email) spheres, time lost from documenting extreme cases and general fear the messages bring can all lead to overwhelming stress, depression and development of unhealthy relationships with others. More and more it may be necessary to screen for abusive behaviors in all aspects of a persons life. 

If and until strict regulations are put in place for actions such as these, many more women will continue to face abuse via the internet. With law enforcement confused or looking the other way when it is reported, and anonymity keeping abusers empowered, the excuses are currently stacked against the girls and women who no longer feel safe or welcome on the internet.

Link to original Article:

http://www.psmag.com/navigation/health-and-behavior/women-arent-welcome-internet-72170/

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Nuevo! - Blogs Para Tu Salud!!

Our Women's Health blog will soon be featuring an ongoing blog series in Spanish! You will be able to access our current and previous Spanish blogs via the "Blogs Españoles" tab at the top of the page (to see Spanish blogs only), as well as on the main blog feed. Look out for this newly updated section, coming soon! 

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New Book Released by Kimberly J. Templeton, MD

Dr. Kimberly J. Templeton recently released her new book, Women's Sports Injuries. This book focuses on areas of continued investigation for which there is evidence of sex-based differences. Check it out! 

For more information please click here to visit the book's official page.

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Start Your New Years Resolution Now!

Many people see each passing new year as a new start to accomplish important goals. However, new years resolutions often come and go as quickly as they began. Many people focus on resolutions to improve their health. Some of the most popular resolutions in the US are:

• Lose Weight
• Quit Smoking 
• Eat Healthier Foods

These along with many others are great goals...but how can you keep your resolution lasting into the new year and beyond. Here are some tips:

1. Start small - New years resolutions are often in the form of drastic changes, which makes them more difficult to adhere to. For example instead of changing your diet 100% when the new year rolls around, gradually change small things throughout the year. Example: If eating healthier is the goal, maybe cut sodas and drink more water in January. Eat one extra serving of fruits and vegetables a day starting in February and so on... You may find that a little at a time goes a long way at the end of the year.

2. Make a reasonable plan to act - Don't make a completely new schedule based on your resolution. This can throw you off balance and cut your resolution short. Instead, fit your resolution within your current schedule. Example: Instead of planning to go to the gym for 3 hours, 4 days a a week, plan a short 30 minute workout everyday at home until you are ready to commit more time to exercise. 

3. Pick based on what is most important to you - Everyone you know working on the same resolution? Don't feel pressure to choose the same thing. Simply working on what is most important to you will give you the greatest results in the end. 

Want Some Help with your Resolution?

USA.gov has complied a list of the top resolutions in the U.S. with links to different resources to help meet your goals. Click on the link above to see if your resolution is there. If not, you may need to do some exploring of your own! Remember, life changes can happen any day of the year. not just on January 1. Cheers!

Also check out this interesting blog post about  resolutions and social media:  http://www.adorecolour.com/why-you-should-think-twice-before-posting-your-new-years-resolution-online/

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Happy New Year!

Happy New Year 2014!

2013, like all years was a year of many triumphs and challenges alike. As you take the time to reflect on what 2013 meant to you and to the world, look forward positively towards 2014. A new year always brings new and exciting adventures...make your 2014 the greatest year yet!

Look back links: 

CDC Top Ten: 5 Health Achievements in  2013 Achievements and 5 Health threats in 2014

Moments of 2013 By Google

YouTube Rewind: What does 2013 Say?

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Personal Reflection: When The Doctor Becomes the Patient

By Winnie Natu, MSIV

While on clinical rotations, I had the good fortune of meeting a wonderful doctor, teacher, and woman. During our time together she shared a personal story that has truly affected me and the way I view the doctor-patient relationship.  As a physician, Dr. X was well aware that her mother dying at the age of 45 of breast cancer meant more than dealing with the grief that accompanies losing a parent at a young age; it meant she herself may have an increased risk of the disease. She was tested for the BRCA gene mutations that are associated with a greatly increased risk of developing breast cancer. Her test came back positive for one of the genes and without hesitation she had a preventative double mastectomy.  

She recalls only half hearing what her own physicians told her about the risks of the procedure and that there was in fact a chance that she might not develop cancer and that if she did, other treatment options may be available at that time.  Of course she was thinking about her children and husband as a motivating factor for getting the surgery but often, she thought of her mother and what her life became in the last years of her life. Dr. X could not let go of the feeling of not wanting to be the patient. After years of being in control of her education and training and later her patients’ health, she could not give up the autonomy and authority that came with that. After years of fighting other people’s illnesses, she could not face that an illness would dictate her own life and so she saw no option but to take control as she had all her life with the mastectomy. 

We as doctors want our patients to leave their WebMD facts and preconceived notions at the door and follow our advice.  Can we do the same? An article on the ACP internist recently posted results of a study that posed clinical scenarios to randomized groups of physicians. Both outcomes involved a choice between surviving a fatal illness but with sometimes crippling outcomes. Physicians were randomized to groups in which they imagined themselves as the patient facing the decision, or in which they were recommending an option to a patient. “The hypothetical scenario involved two types of surgery for colon cancer. The first type of surgery cures colon cancer without any complications in 80% of patients, results in death within two years in 16%, and 1% a piece would experience a colostomy, chronic diarrhea, intermittent bowel obstruction or a wound infection. The second type of surgery cures 80% without complications, or results in 20% mortality within two years. Among 242 respondents, 37.8% chose the treatment with a higher death rate for themselves but only 24.5% recommended this treatment to a hypothetical patient”.

These and results of other studies like this tend to highlight the same concept for me: it is imperative to get to know your patient. Doctor, lawyer, teacher, home-maker: each comes with their own set of personality traits, priorities, social/financial circumstance, and personal experiences. Knowing these characteristics as a physician allows for providing individualized medical care that will tend to have the strongest compliance and best long-term outcomes for the patient.  Our job after all, is not to always carry out what we think is right but often what is right for each patient. Moreover, what Dr. X described: the unwillingness to give up control, the thought that “I know what is best for me”, fear of vulnerability etc. is not restricted to physician patients! It is important to remind ourselves that our patients, regardless of profession, have at least some of these feelings every time they come to us and that it is a great privilege that we are entrusted with their care.

Link to ACP internist: http://getbetterhealth.com/evidence-that-doctors-make-bad-patients/2011.04.18

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TGIF Quote of the Week

This is the last Friday in 2013! Hope everyone is able to make it a great one!
Here is the quote if the week:


"It always seems impossible until it’s done."
                            - Nelson Mandela

Think back...what did you do in 2013 that you thought was impossible? Keep on accomplishing the impossible as impossible things are happening everyday! 

Have a great weekend! 

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Healthy Holidays!!

While the winter holiday season can be the most magical time of the year, it is also a time when many engage in not-so healthy behaviors. Large amounts of holiday treats, stress over holiday spending and being in large groups as cold and flu season hits can all have a negative effect on your health. The CDC has created a fun holiday song called "The Twelve Ways to Health" , providing a great way to remember all the things we sometimes forget in the rush of the holiday season. On the CDC's page, along with the lyrics, are resources to learn more about every topic are provided. Take some time to sing along and get information about a topic you may want to know more about. When you make the holidays healthy, the happiness come naturally!

                 

ENJOY THE HOLIDAYS!

Links: 

Twelve Days of Health Lyrics and Resource Page

Twelve Days of Health song/video

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TGIF Quote of the week!

Happy Friday everyone! Have a relaxing weekend! hopefully you are or soon will be having a holiday break! Here is our quote of the week, which is especially good for this time of year. While many are looking for holiday cheer; the stress of shopping, cooking and get-togethers can make people the opposite of what you would expect from this time of the year: 

A healthy attitude is contagious but don't wait to catch it from others. Be a carrier.-Tom Stoppard 

Choose the healthy attitude....you many be the one to spread it!

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Rheumatoid arthritis

By Justine Shum, MSIV

Rheumatoid arthritis (RA) is an autoimmune disease that most commonly presents as an inflammatory arthritis affecting the joints. Like many other autoimmune diseases, RA affects more women than men -- about 3x as many women have the disease.

RA is a chronic disease that cannot be cured, but there are now many medications that are effective in reducing symptoms and slowing the progression of the disease. These medications are classified as disease-modifying antirheumatic drugs (DMARDs), and can further be separated into conventional DMARDs such as methotrexate and sulfasalazine, and biologic DMARDs such as rituximab and adalimumab. Because of DMARD use, the severe RA that results in crippling joint deformities is fortunately becoming more rare.

Current recommendations call for treatment with DMARDs to begin once a diagnosis of RA is made. Many patients wish to delay treatment, however, recent studies have shown that early and immediate treatment of RA results in lower disease activity in patients. These studies also show that at 2 years following diagnosis, patients who received immediate treatment were less likely to have joint damage and resultant disability.

Patient education of the disease course of rheumatoid arthritis and the consequences of delaying treatment will likely make the difference in patients who are wavering on initiating DMARDs. See the links below for some basic patient education material provided by the American College of Rheumatology.

Links:

http://www.hss.edu/newsroom_timely-treatment-reduces-ra-disability.asp

Patient education (English): http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Rheumatoid_Arthritis/

Patient education (Espanol): http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Artritis_Reumatoidea_(Espa%C3%B1ol)/

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"Good" and "Difficult" Patients

Whether you work in healthcare, have been in the healthcare system or simply watch medical dramas on TV, many are aware of the concept of "good" and "difficult" patients. "Good" patients are simply compliant with what is happening to them, low maintenance and an have an agreeable family. "Difficult" patients may ask too many questions, insist that they need immediate care or suggest things that their providers do not agree with. The article "Good" Patients and "Difficult" Patients - Rethinking our Definitions, by Louise Aronson, M.D. Challenges these images that are bestowed on patients and families by sharing a personal sorry about an experience with her elderly father. This is a great read for physicians and patients alike. Check it out by clicking the link below!

 "Good" Patients and "Difficult" Patients - Rethinking our Definitions



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