Category: Health Care

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Healthcare as Selfcare: A Bold Plan for 2021

I have never been a fan of New Year’s Resolutions. Why? Because people tend to come up with these grand plans that they only stick to for 1-2 months and then gloriously fall off the wagon. However, what I do tend to notice is that at the end of each year, I naturally tend to reflect on the year, seeing if I’ve grown as person. Have I improved on the human I was the previous year. How do I want to improve in the next year? I think it’s a natural closing of a chapter.

This year has been like no other in most of our lifetimes–it has brought about a different kind of stress, a different kind of reset. And so, at the end of this year, it does bring about a different kind of reflection.

My friend has given me the honor of being a part of her wellness retreats and speaking on physical health. We began just trying to pick up the pieces that COVID had shattered. Next was a REFOCUS, as we shifted our vision back to those things that could keep us healthy in mind, body and spirit (I, of course, focus on body in my sessions, but fully agree in the whole approach). This time, we REBUILD, as we plan for how we will enter 2021, in a new head space.

I want to caution everyone from thinking that 2021 will be perfect–because we all entered 2020 thinking it had to get better than 2019, and look what we got…lol! So I think the first lesson is to be prepared for ANYTHING, and GRATEFUL in EVERYTHING!

As we prepare to rebuild in whatever 2021 has to offer I want to remind us that healthcare IS selfcare, and if we’re going to achieve it, we must plan for it. Here’s the first steps.

Get Your Mind Right

A few important principles:

Be realistic about your preferences and your lifestyle. If you don’t, you are setting yourself up for failure. If you already wake up at 4:30 for work, you likely aren’t going to get up earlier to do anything. If you don’t eat green foods, you likely aren’t jumping straight into plant-based. Don’t set yourself up for failure. Set small, realistic goals, and celebrate every small win.

You want a schedule, and not a to do list. A to do list tends to make you feel a little like you have a never-ending list of things you didn’t get done, and reinforces a failure mind set.

We have to start by believing that it can happen. “Fake it til you make it.” “Speak it into existance.” “Believe it and you can achieve it.” For me, it all came together when I read the book Psycho-cybernetics and was confronted with science and real world examples of the self-fulfilling prophecies and self-limiting beliefs that everything came together. It made the practice of affirmations make sense. So part of what I want everyone to do is assign an affirmation to each piece of what you plan to accomplish as you move through your plan of self improvement, because whether you believe you will or you won’t, you’re right!

Remember, imperfection is okay, giving up is not. Plan for imperfection. Know that you will not be perfect, and there will be moments you’re going to have to pick yourself up from falling off the proverbial wagon or horse or whatever. Plan to fall AND GET UP EVERY TIME.

Rest

I always start here because if you aren’t resting well, nothing else in your life will go well. You must get enough sleep (7-9 hours nightly for adults) in order for good mental clarity. However, it also regulates weight, blood pressure, blood sugar, appetite, cardiovascular health….you get it, it regulates a great deal. You need sleep. Additionally, you need other types of rest: meditation, mindfulness, and play. Don’t forget that we are not designed to be on all the times. Studies show that we are more productive and healthier when we incorporate the right types of rest into our lifestyle.

Rest Plan

Example: Set your reminder on your phone for when your evening ritual should begin. Commit to having this relaxing time and going to bed at a relatively regular time.

Exercise

Exercise is beneficial for so many things. It helps control weight, improve cardiovascular health, decrease joint pains, strengthen muscles, improve cognitive function, control depression and anxiety, strengthen our immune system–again, I can go on and on. I like to think of exercise as the fountain of youth. If you don’t have an exercise plan, this should be high on your priority list. Jogging as little as 7 minutes daily can make a difference in cardiovascular health, and 150 minutes of moderate intensity cardiovascular exercise weekly is what is considered an active lifestyle (75 minutes of high intensity)–that’s just 30 minutes daily. Truly, being sedentary is one of the greatest risk factors for an early death, and we are all doing much more sitting with working from home, zoom meetings, etc.

Exercise Plan

Examples: 1. Commit to walking 30 minutes daily during a meeting that can be off camera. 2. Commit to waking 30 minutes earlier to zoom a zumba class. 3. Commit to walking 10 minutes on breaks three times a day. *Hint* You can multitask and watch videos for a class, watch taped shows, or be in a meeting while being on a treadmill, bike or elliptical

Feeding our Bodies Well

The old adage says “You are what you eat” and it’s proving more and more to be true. I like to say, “You get out what you put in,” and I think of food as the ultimate medicine. It’s so important to choose foods well, because our diet plays an important role in our over all health. Your choice of diet should really depend on your personal risk factors and natural tendencies, but generally sticking to a healthy plate won’t steer you wrong, and I like to teach this often. When you are picking which diet you’d like to go with, please remember that it’s important to consider your preferences, your lifestyle–be realistic, because consistence is key. The important think is that plants are your friend, whole foods are your friend, and it’s important to watch your portions. To learn more about the individual diets, select the links: Plant-based, Keto, Intermittent fasting, Mediterranean

Food Plan

Examples: 1. Have a grocery day and a cooking day *Hint* It only takes about 30 extra minutes to cook several sides and prep proteins for the week. 2. Commit and budget to purchase meal prep. 3. Consider grocery delivery if not already participating.

stay One Step Ahead

We have to stay one step ahead of our health by being on top of our screenings preventative health. This means going to our doctor’s visits, knowing what our numbers (cholesterol, blood sugars, blood pressures, BMIs) look like, and having a long term plan for our health. We need to make sure we are on top of screenings such as colon cancer screening, cervical cancer screening, breast cancer screening, osteoporosis screening, and cardiovascular screening, lung cancer screening and prostate cancer screening (age, gender, and risk specific). We also need to get our eye and dental exams. Don’t let these things fall to the back burner–prevention is care–I have saved lives through early detection.

Prevention Plan

Example: 1. Look at your schedule now to begin booking your healthcare appointments and scheduling that time. 2. Budget for the money you may have to spend on additional tests. Healthcare unfortunately does cost money in the United States.

Chronic Illness Control

This year has really thrown us for a loop, and it may be time to refocus on getting some chronic illnesses under control. The things above are important factors in controlling chronic illness, but if you have hypertension (high blood pressure), it’s also important that you be monitoring those numbers. If you have diabetes (high blood sugars), you need to be checking these numbers as well. It’s important that you have the supplies needed and that you make the time to monitor your health status. It’s also important that you take the time to make sure you are taking any prescribed medications that help keep your chronic illness in check. With my migraines, I have a few pharmaceuticals that help me manage my headaches–one is daily, one is monthly, and one I have to go in for quarterly to for injections. I will confess, I struggled for while with that daily medication–but I had to come up with some schedule to help me remember to get it in. I also have to make sure I make my quarterly appointments–and not just that–my weekly to biweekly physical therapy appointments, and as much as I hate working that into my schedule, it must be done. Make sure you are planning ahead and making the time to take care of your health.

Chronic Illness Control Plan

Example: 1. Attach taking your medications to an action that you do daily. Don’t do it until you’ve taken your medication. 2. Commit to taking your health measurements whatever prescribed frequency. Come up with a similar adherence plan.

US

Remember: this whole thing has been about us being on the schedule–us being a priority on our list. Don’t let the excuse for not accomplishing the above be because you were too busy doing something for the other people (husband, kids, employer) on your list. You are important. You matter. You are first on the list. Make it happen.

So remember, you need to book you me time. Sit with a work calendar and pick some days or afternoons off in advance–plan for those preventative care visits. Plan for your rest time. Plan for your exercise. You deserve it.

Example Affirmations

  1. My body is a temple and deserves proper maintenance and care.
  2. I prioritize rest and my health because I am important.
  3. I have presence of mind and choose my response to stress. I eat when I’m hungry–not emotional, and stop when I’m satisfied.

I invite you to share some of yours that you will use to help you on your journey to better health in the coming year!

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SARS-CoV-2: All your questions answered–UPDATE

It seems that Sars-CoV-2 is the gift that keeps on giving. It’s interesting. When I was first discussing the true scientific impact of what was becoming a pandemic with my father, he looked at me and said something like, “This is going to change everything forever.” I thought he was being a little over dramatic. Silly me. I should have known, my father, who is really not the dramatic type, just fully grasped the social part of the situation while I was merely blinded by the science.

My minister approached me and asked me to do this thing sort of out of my comfort zone. I like being behind my computer and writing–or one on one with a patient. But also, when you’re called to use your gifts, you do it (Luke 12:48, Matt 25:14-30)–so I said yes. Below are questions we’ll discuss. I’ll make links available as I find we discuss topics, and will try to update the topics with more detail based on questions. But please be gracious–I do have a full time job and children :-).

What is SARS-CoV-2? What is COVID-19?

How does Sars-CoV-2 operate and how does it affect the body?

 What are the symptoms of Covid-19?

What groups are most at risk?

What are some of the steps for protecting ourselves from the virus?

From a medical perspective, are we doing the right thing by practicing social distancing, and shutting down businesses?

What medical treatments are available for a person who contracts this virus?

What does the recovery process look like?

When should a person be tested?

How do testing sites work? What options does the uninsured person have?

Premiere Episode of “Prescriptions for the Pandemic“

Second Episode of “Prescriptions for the Pandemic”

Previous COVID-19 post

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It’s Likely A Virus…Or is it?

Its that season…

Pumpkin spice everything. Soup. Chili. Beans.

And, yep, germs EVERYWHERE!

In honor of my first evil toddler cold of the season (for the record it’s currently 2-1 in favor of my regimen—Daylight savings threw off my Spidey-sense), I figured I’d share some insight on how to tell when you may be dealing with influenza vs common cold, common cold vs bacterial complication—meaning now you need to see a doctor and get some of the double-edged sword that is an antibiotic, or it may be strep…which generally, adults aren’t dealing with unless they’re around germy children. Yes, children are little incubators, and I never got sick before I had them. They’re lucky they’re cute!

INFLUENZA AND STREP

COMMON COLD

SYMPTOMATIC THERAPY

VITAMINS AND HERBALS?

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Symptomatic Therapy for Upper Respiratory Tract Infections

The most important therapy right now is symptomatic. I am not a fan of combined formulations, because I prefer to target my specific symptom set, and I generally will just deal with the achiness and omit the Tylenol/acetaminophen or Advil/Motrin/ibuprofen that’s typically always a part of the combo meds. Also, the antihistamine in combination medications are typically short acting, and wear off in the middle of the night, resulting in waking halfway through the night feeling miserably, or having to dose every 4 hours. It’s just a lot. I prefer things that can be dosed once or twice a day. However, you can also use this as a way to make sure your combo med is treating all your symptoms.

For runny nose:

Antihistamines: Claritin/loratadine, Allegra/fexofenadine, Zyrtec/cetirizine, Xyzal, Benedyl/dyphenhydramine (short acting, but dries better)

Pseudophedrine/Sudafed (decongestant, but dries—shouldn’t be used if you have high blood pressure)

For post nasal drip and congestion:

Fluticasone/Flonase

Nasonex/mometasone

Pseudophedrine/Sudafed (decongestant, but dries—shouldn’t be used if you have high blood pressure)

Saline irrigation with something like Nettipot, Arm & Hammer Simply Saline or a store brand irrigation

Chest congestion:

Mucinex/guaifenasin

(Will not help dry up, but will help it come up, which is very important! You do not want that mucus blocking the airways and growing bacteria)

Vick’s VapoRub

Cough:

Generally, during the acute phase of illness, cough is protective. You want to cough mucus up, and I don’t like to suppress cough until I know the cough is residual. The goal is to decrease the mucus and decrease the need for the body to cough. Also, Vick’s VapoRub, cough drops, and lots of warm fluids.

Muscle aches/ Headache:

Ibuprofen/Advil/Motrin

Tylenol/acetaminophen

Sore throat:

Ibuprofen/Advil/Motrin

Tylenol/acetaminophen

Salt Water Gargles

Lozenges

Other Notes

Vitamin C, Zinc, and Elderberry may all have roles in shortening viral illness. I recommend my patients add them to their regimen if they have no metabolic (liver, bone, or kidney) issues.

REST is so important in healing. Try to get as much rest as possible to prevent developing a secondary bacterial infection. When I give the above instructions it’s my goal to prevent the need for an antibiotic prescription.

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Common cold

The overwhelming majority of calls I get, wanting to be seen for waking up “sick,” or “coming down with something” are some variation of a normal viral illness This is the typical time frame:

Day 1-2: feeling a little off. You may be more tired than normal. Maybe your throat is more scratchy, nose is more itchy, but it’s really easy to miss if you’re busy, or there is some other explanation.

Day 3: I’m normally called on this day. Today you feel pretty bad and you have known you haven’t felt like yourself for a couple of days. You are starting to really have the common symptoms, may be feeling a little achy, but less so than the flu, and you have some more intense fatigue today. Now is when you definitely have some sort of runny nose or congestion or sore throat or cough–something to let you know you’re sick.

Day 4: Today is definitely worse. Honestly, no matter what I do on day 3, it’s going to be worse. You feel like crap. There’s mucus everywhere. Sorry.

Day 5: If we do everything right, this is the day the systemic symptoms should start to improve (meaning if you ran a fever, it should stop, you should have fewer body aches, be a little less tired, etc), but if it’s going to move into your chest, it will start to do so today if it hasn’t already.

Day 6 and beyond: you will be coughing but you should be improving overall. If you get worse systemically at this point, it’s time to call your doctor. You likely need an antibiotic. However, remember, the cough can hang around for a while and be QUITE annoying.

Prevention:

How do we prevent the common cold? Wash your hands. Wipe down your surfaces. Eat a healthy diet. Get plenty of rest. Pay attention to your body. What I have found is that if I can catch myself in day 1 or 2 when I’m just feeling more run down, I can keep myself from really hitting the sick of day 3 if I 1. Rest, 2. High dose C, 3. Zinc lozenges, 4. Elderberry Syrup. I can’t find any evidence to say that this works for everyone. It works for me.

Treatment:

You missed your window of prevention and you’re in day 3? Ride it out. There is no medicine that’s going to kill a virus. That being said, vitamin c, zinc, and elderberry are very promising for shortening the duration of a viral illness, again assuming no kidney, liver, or metabolism issues (so make sure you check with your personal doctor before use). I also tend strongly advocate for treating your symptoms, because untreated mucus symptoms are the biggest cause of bacterial infections in my completely subjective opinion. I like to be able to prevent the need for antibiotics, so I give my patients the run-down on what to use to dry it up and keep what’s in there rinsed out or flowing out. See the post here. Mainly with a virus, you gotta just suck it up, and ride it out. Get some REST!! As a society, we highly undervalue it, and it’s so important to our recovery. And remember, the annoying cough can last for up to 1 month, but it shouldn’t be associated with fever, chills, night sweats, or shortness of breath. And generally, your docs may have a prescription up their sleeves for this annoying cough if you ask.

Secondary Bacterial Infections

Understand that it will normally take 10-14 days for a bacterial infection to develop after a common cold if it’s going to happen. ENT studies have shown it takes at least 14 days for bacterial sinus infections to develop, so even if you’re have classic sinus infection symptoms, it’s likely from a non-bacterial cause if it’s prior to 14 days. It just takes that long for enough bacteria to grow to be causing an infection. Before this, you likely don’t need antibiotics unless you have some kind of special risk factor.

At this point, I normally want to see my patients. I want to make sure you aren’t more sick than you think, and I want to localize the infection to make sure I pick the best antibiotic for your infection. All antibiotics are not created equal, so please don’t use the last antibiotics you had for the infection you might have right now unless you’ve received the okay from your physician.

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Flu and Strep

With both of these, you generally are much sicker than with the common cold. You may be running fevers, but you definitely feel like you should be in bed, and generally, aren’t going to be able to ignore your body for long. They are typically accompanied with severe body aches and headache. If you think you have one of the above, it’s normally best to contact your doctor.

Influenza

In most cases, influenza is fast and severe (although if you’re vaccinated, it can really change the way it presents if you still catch it). You think you may be getting sick, and by the end of the day, you think you’re maybe dying…lol. There are typically body aches, runny nose or post nasal drip, sinus congestion, cough, and chest congestion. There’s also frequently gastrointestinal symptoms like nausea, vomiting or diarrhea. Fever is typical, but the absence of fever doesn’t mean you don’t have the flu.

Normally, you get sick within 2-3 days of exposure to flu.

For the best way to prevent the flu, and for loads more information, see this blog post.

Treatment: For certain populations, not all, antiviral medications are recommended. These medications are recommended within a certain timeframe (usually within 48-72 hours of symptom onset) so contact your doctor as soon as possible if you’re suspecting flu.

In my research on my favorite advice for common cold therapies, I found out that elderberry may just have activity against influenza. If you have a healthy liver and kidneys, it may be worth adding to your treatment regimen if you’re recovering from flu.

Strep

Strep throat can accompany other infections, but generally, pure strep throat is not associated with the other symptoms of an upper respiratory illness. Fever, sore throat, headache are the mainstays of this illness. Having cervical lymphadenopathy (swollen glands in the neck) makes it more likely, but this can happen with the other illnesses as well.

Generally, you feel as bad with strep as you do with the flu…one of the main times that i figured out I had the flu was when I said to myself “I haven’t felt this bad since I had strep.” So yeah, you feel horribly.

However, it’s not common in adults. Typically you will have been exposed to younger children in order to be at risk. You will need to be swabbed, but also, make sure that whoever is swabbing looks at your throat. I will normally treat if the throat looks like classic strep, (it does have a very classic appearance) or if there is known exposure and the symptoms are super classic, since the rapid test is not 100% accurate.

Treatment is generally with amoxicillin of some sort. If you’re allergic, a cephalosporin, clindamycin or azithromycin will do.

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I *HEART* My Exercise

One of my fave shots of me and bestie1 getting it in.

But I’ve been exercising every day for the past X months, and I still haven’t lost weight…

I can’t tell you how many times I’ve heard that line in my office.

Or the response to the question “What are you doing for exercise?” that for some reason is immediately answered with their weight loss efforts, or how they know they should lose weight.


PEOPLE!! Exercise has lots of benefits—some of them have to do with weight, BUT that’s not all of it.

First, let’s talk about what exercise does for weight. Weight loss is 80% diet, 20% exercise. So, you can expect a small amount of weight loss from exercise if you have been completely sedentary, but don’t expect a great deal. What you can expect is weight stabilization. What we find in patients who have been successful in weight loss and kept that weight off for a substantial amount of time (years) is that they are exercising regularly. In addition, I tell my patients, the exercise is COSMETIC. It’s what’s going to help your body look like you want it to look, regardless of whether the scale changes. But for me, these are all extremely superficial to why I am asking people to exercise. Below are just some of the many reasons I like to encourage my patients to GET MOVING!!

  1. Exercise improves memory and thinking skills.
  2. Exercise improves symptoms of depression and anxiety.
  3. Exercise improves insulin resistance.
  4. Exercise improves blood pressure.

In fact, this infographic highlights many of the benefits, from improving bone health to improving sexual health, including some of the things mentioned above.

My active and youthful octogenarians swear by exercise, and swear it helps keep them youthful, active, and they have less achyness when they are exercising regularly.

I encourage exercise at every age. I prescribe it first for almost every chronic ailment. You will hear me mention it often. And it doesn’t have to be much depending on what benefit you are going for.

I actually recently read this article that cited a study that showed that only 7 minutes of jogging daily can cut your risk of heart attack and stroke nearly in half, and adds to your life. I’m huge on circuit training and HIIT training to maximize your time when it comes to burning fat and building muscle—and these workout generally can provide major results in minimal time. But honestly, I encourage people to move in ways they enjoy, swimming, dancing, biking—whatever makes you happy, and is something you will sustain, is something you should do. If you hate walking on a treadmill—don’t buy one. Stop using the heat of the Houston summer as the reason you don’t work out—it’s hot EVERY SUMMER! Come up with a work around.

MOVE! Not to lose weight either. Just because it’s good for you.

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Flu Season is Coming…

Protect yourself!!

Okay! So I’m here to talk about vaccines again. Why. Because vaccines save lives, VACCINES SAVE LIVES! And I always say, I chose adults because I want to be able to sleep at night knowing an adult made a decision for themselves, but it’s my job to EDUCATE! So that’s what I’m here to do folks. Do with the info what you will. But do understand, that your decisions do impact others—it is definitely a public health issue.

So here goes…

(First, if needed, to review the basics of general vaccination click here)

Why should you be vaccinated against the flu? Although it’s quite common, and it comes in different versions every year, this is not the cold, folks. This is the BIG BAD. This thing kills and maims. In fact, most years it’s responsible for 30,000 deaths, and in really bad years, like 2017, it can be responsible for up to 80,000 deaths. You know why those numbers are getting so high? BECAUSE PEOPLE WON’T GET THEIR VACCINES. Because it spreads like wildfire.

I previously didn’t spend a lot of time trying to convince relatively young healthy adults to try to get the flu vaccination. Then something started happening while I was in residency. I started noticing that people my age were dying of the flu. That wasn’t something that we were used to seeing. And then it was happening every year. So I felt like it was something I really needed to start talking about.

Why does it spread so quickly?

People are contagious before they know they are sick. So they are walking around shopping, going to school, work, thinking it might be allergies, and all the while spreading a highly contagious, airborne virus. Once they are sick, they’ve likely been making others sick for 48-72 hours.

Why is it so deadly?

Influenza is VERY fast. It replicates quickly and overwhelms our immune system. It continues to replicate quickly and starts to overwhelm our organs as well. When we have the vaccine, our immune system is prepared to fight, and even if we get sick, it can keep our organ systems from being overwhelmed.

Who is most at risk?

Really young people (children under 5), our more seasoned citizens (our immune system gets weaker as we have more and more birthdays), people who have certain health issues (ie. Asthma, diabetes, cancer, COPD, heart disease, kidney disease, liver disease—to name a few—see a full list here. Why do those of us not in these categories get vaccinated? To protect ourselves, but also, to protect our loved ones who fall into these high risk categories.

What are the benefits of the flu vaccine?

There is long list here, but to highlight a few, it has been shown to reduce risk of death in children, ICU days from the illness, risk of cardiac events, and pregnancy related lung disease. It also reduces doctors visits related to flu illness, and overall severity of the illness.

What are some of the risks of the vaccine?

The risks are very low. Injection site reactions are the most common side effect. Feeling a bit run down 1-2 days after the injection can happen, but is generally a mild reaction. I normally explain this  as an immune system flair, but on review of the evidence, it actually occurred at the same frequency in people injected with the actual vaccine and salt water (placebo), which means this is likely NOT a reaction to being injected with virus. Please see below links to see the CDC discussions on the almost non-existent risk of Guillain-Barre Syndrome and the reasons you shouldn’t be worried about the amount of thimerosal.

The flu shot is so important, but this article reports that only half of adults plan to get it and only 40% of adults got it in 2017-18 flu season. People—this is why more and more young adults are dying of flu. And it’s PREVENTABLE. I don’t want it to be my patient or my friend, my family member, or my church member. Remember, I don’t get paid to do this—I just spent the past hour or so writing this blog post simply to try to spread awareness on this important topic. Not for a bonus. But because it’s my calling. Because I believe in it. Because it’s science, and it’s public health, and it’s people’s lives. You only get one.

Below I have linked some great reference pages from the CDC page. Also, maybe take some time to click through the side links, it’s really great information for anyone truly interested.

Key Facts

Who Needs and When

Misconceptions about the Flu Vaccine

For those worried about Guillain-Barre Syndrome

For those worried about thimerosal

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My Responsibility

https://jm-aq.com/wp-content/uploads/2013/10/stop-domestic-violence-logo.png?fbclid=IwAR1Y6SH03oI5U4QIpjKFIJtZZmdPYjJXe-kZhqMkgdo1E1tlGxuZhyAZQPc

October is Domestic Violence Awareness Month. I have a church member-friend-inspiration who has a non-profit organization that is all about Domestic Violence, and last year I had the opportunity to attend the organization’s annual brunch for the first time.

Her Voice is a mentorship program that supports victims of domestic violence in the first 2 years after they leave their abuser, since this is when they are most vulnerable to return to the situation.

My eyes were truly opened, and I realized that as a physician, I felt unprepared to handle this incredibly important topic. Sure, I knew I was supposed to be asking if my patients felt safe in their homes, but what was I supposed to do if they said no? So I’m sad to say hadn’t been doing my part.

I promised myself I was going to do better, in part because Dr. Shana made is very aware that ending Domestic Violence was each of our personal responsibilities. But I’m ashamed to say after a few failed attempts at trying to put a tool kit of resources together, and a few struggles of my own, I let this important topic fall to the back burner.

Well, here we are again, a year later, and I am at this fantastic event again. The transparency was unparalleled as the emcee shared that she, too was a victim of domestic violence and was having to work through some of her feeling surrounding being central in the event.

Dr. Shana defined domestic violence as “a systematic way of destroying a [person] from the inside out.” She also hit us with some very troubling statistics. Every 9 seconds a woman is abused. One out of every 3 women (and one out of every 4 men) will experience domestic violence in their lifetime. And Harris county, the county in which we reside, leads Texas in domestic violence homicides. I actually had to look this up , guys. And what I found troubling is that this has been a pattern since at least 2015—and as she said, this is NOT where you want to be #1.

We later heard from one of Her Voice’s mentors, a domestic violence survivor, who shared her story of survival. Truly touching she shares how she “wanted and needed to be loved.” How she “thought she’d found Mr. Perfect”, and he had a broken past, and “she wanted to help him” but he flipped the script on her. His mom was even in on it, and tried to tell her how she could be have to try to avoid the abuse. It finally ended, but she almost lost her life. As she says, she finally realized that “Love does not hurt you, degrade you, mistreat you, or isolate you.” She is now in a loving relationship, and her husband was there to support her, beaming with pride as she shared her story, a perfect example of the theme of the the event: Shattered, but silent no more.

So the beginnings of a tool kit:

What is Domestic Violence?

Houston Hotlines

713-528-2121—Domestic Violence

Houston Area Women’s Center Shelter

Houston Area Women’s Center Counseling

List of Houston Area Resources

Also, I don’t want to forget to tell my Houston area people that there is a concert hosted by Men Against Domestic Violence later this month. For more information click here.

 Domestic Violence is a silent killer. 1 in 3 women, guys. That means if you don’t know anyone, it’s just because she hasn’t told you. So if you’re worried about your friend, ask some questions, without judgment. Let her know you’re there for her. Share some resources.

Whose responsibility is it to stop domestic violence?

MINE!!

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BREAST CANCER AWARENESS

Two days into breast cancer awareness month, I diagnosed my first breast cancer of the month. It was recurrence in one of my long time, favorite patients. Your favorite patients—it’s funny, they’re not always the ones that do the right thing. They just generally have personality traits that remind you of yourself, or your family members or friends. This one—she never does what I say. In fact, she only got this screening done because I happened to realize I hadn’t seen her in a while and reached out to fuss at her. Thank God I did. We caught it early. She’ll beat it. That, my friends, is why we screen. For that feeling of knowing that we will be able to save a life because we caught something early.

Last year at Susan G Coleman Race For The Cure with a fave–no judgments!! I look a little rough.

Who should be screened?

Different groups feel differently*, but we should begin discussing it around 40 (this will depend on personal risk factors) and most people should be being screened by age 50.  By 75, or if someone is expected to live less than 10 years due to illness, there isn’t data to support that we are going to do more good than harm by continuing to screen.

How often?

American College of Physician recommends every 2 years if you are at average risk. At increased risk, or findings on mammography would change this recommendation.

With what?

Mammography. Clinical breast exams really aren’t quite as good as mammography and are prone to false positives and over testing. Home breast exams are similar, though I always encourage women to know their bodies well.

Truthfully, there are two sides to every coin. And there are both risks and benefits of every treatment, every screening. It’s why these recommendations are so confusing. Every group is trying to make sense of them.  And since you may or may not have had the opportunity to have this talk with your physician, I’ll share some basics here, from the information I learned from the American College of Physician Guidance Statement on Breast Cancer Screening in Average Risk Women released earlier this year.

Average risk patients are between the age of 40-74. Things that change your risk include:

  • history of breast cancer or high risk lesion
  • history of known genetic risk (meaning genetic testing, not remote family history) with testing showing you are a carrier of a known gene that increases your risk
  • radiation exposure to the chest in childhood
  • The thought is that increased breast density may increase risk a very small absolute amount that may or may not be clinically relevant.

Things that do not increase your risk

  • Early menarche (onset of menstrual period)
  • Late menopause (stopping of menstrual period)
  • Long term contraceptive (birth control) use
  • Menopausal hormone therapy

What are the benefits of screening by age?

The US Preventative Task Force Services conducted a study that states that mammography has reduced the number of deaths due to breast cancer by age group as below:

40s: 3 per 10,000 women screened in 10 years

50s: 8 per 10,000 women screened in 10 years

60s: 21 per 10,000 women screened in 10 years

70-74: May be 13 per 10,000 women screened in 10 years.

Of note, the only “statistically significant” values are in the 50-69 age group, which is why you see the recommendations focus so heavily on these women. Also, note the most lives saved are in the 60s age group.

So what are the risks?

About 20% of women diagnosed with breast cancer in a 10 year period will be “over-diagnosed and overtreated.” This means they would not have been harmed by or died from their breast cancer had it not been treated, and therefore will only experience harm by any therapies we add to their lives.

Other harms include:

  • False-positive (test is worrisome even though woman doesn’t have cancer
  • Psychological harms (worry and distress from tests and procedures)
  • Pain from tests and procedures
  • Some women believe lack of shown reduction in all-cause mortality (death from any cause) constitutes a harm
  • Mammography specific harms including radiation exposure, and the risks associated with this.

This is a real risk we must consider when we make recommendations for screening, and it’s why you see us beginning to relax the guidelines.

If you need screening and are uninsured, there may be an organization in your area that has a program. I know in the Houston area, The Rose is one. Feel free to look into it. An evidence-based screening regimen is an important part in a preventative lifestyle. If you are between 50-70, there is no doubt you should be screened. DO IT!

*See links to different guidelines below:

American College of Physicians

USPSTF

American College of Obstetrics and Gynecology

American College of Radiology

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