Preventive medicine really is a stitch in time

July 14, 2004|EMILY TOADVINE

The annual trip to the doctor is something many women would just as soon postpone. But the trouble is, those who delay the visit often wind up totally skipping this important checkup.

The American College of Obstetrics and Gynecology recommends women have a pap smear every three years, but most doctors would rather see it done annually.

"Mainly, if you give a woman permission to wait three years, three years becomes five," says Dr. Susan Coleman of Danville Women's Care.

In addition to having a pap smear, the annual visit is the ideal time to talk about overall health.

"You miss all the opportunities to educate about bone health, weight, diabetes and exercise - all the things we routinely talk to women about when they come for their annual exam."


Coleman isn't sure why some women avoid the annual visit.

"I think we're a nation of procrastinators. I sometimes have to urge them to do it because they fear pain. I've had several say they fear the unknown."

Hiding from the doctor is not the answer. Preventative health care is.

"Breast cancer is curable if found early," Coleman says.

Vicki Vernon, a nurse practitioner at Boyle County Health Department, says no one woman should be able to use cost as an excuse not to have an annual exam.

"We offer mammograms and pap smears. The cost is income-based, but no one is refused services for inability to pay."

The health department also has programs that cover the cost of cancer treatments, but the women have to be over age 40.

Dr. Michael Glover of Glover, Harrison, Ahnquist and Alexander says there are two big favors women can do for themselves to beat the odds of having health problems.

"Women's family history plays a large role, but being overweight and smoking are the biggest factors in women's health," he says.

He says two tests should be performed annually.

"The biggest thing in women's health has been in doing the mammograms at the scheduled time. And continue to do pap smears on a regular basis."

Mammograms can detect microcalcifications, he says.

"Even self breast exams would not have picked these things out."

He observes that even women who have had hysterectomies need to have an annual exam.

"We pick up five to 10 patients a year in our practice, who have had hysterectomies who have abnormal pap smears."

Pap smears will alert doctors to such problems as dysplasia.

"If that had not been done, a visible tumor would have been the first indication."

Family history plays a role in when patients should have checkups, Glover says.

"If the patient has a positive family history for colon cancer, I recommend a screening procedure after age 45."

Everyone over age 50 needs a colon exam, he says.

Another important screening is for osteoporosis.

"With proper education, we should be able to drastically reduce hip fractures in women with proper screening."

He recommends having osteoporosis screening no later than age 50 and sometimes earlier if there is a family history. He observes that use of thyroid medications increases the risk.

"The earlier you catch it, the better off you are," he says.

Cholesterol screening applies to everyone.

"We're hitting stronger on ladies for cholesterol screening because heart disease is a big issue for women's health. We almost recommend it at any age now."

Even with the regular checkups, women should be the most attentive to their diet and stop smoking. "One of the biggest problems is weight. They come in for weight control and discussions of diet."

Being overweight leads to problems.

"That causes abnormal bleeding in the menstrual cycles."

Many times, women will not worry about their diet until they have a wakeup call.

"Sometimes, it takes a crisis to get someone to realize. They've had chest pain and they find out they need to lose weight and get their blood pressure down. When the Grim Reaper looks you in the face, it's an impetus to do something," Glovers says, noting that he and his partners see a lot of women smoking, particularly during pregnancy.

Coleman says that she thinks many of her patients have quit smoking.

"We as a society have become aware of the dangers of tobacco."

Weight control continues to be a major concern, Coleman says.

"Three-fourths of my patients bring up weight control. We talk about weight training. Women lose muscle mass. We talk about strength training."

Strength training is vital to combating osteoporosis. Coleman recommends this screening the mid-30s.

"Our generation, we're not milk drinkers. We drink pop. Soft drinks leach calcium from the bone."

Coleman says the "big three" tests for women to have beginning at age 35 are lipid screening, glucose for diabetes and thyroid. These tests should be repeated every three to five years.

It's best to start preventative healthcare at an early age, Vernon says.

"We recommend yearly blood pressure and cholesterol screening beginning at age 21 and every five years if normal."

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