Skills For Success
January/February 2003
Here's to Relearning the First Skill We Forget:
How to Take Care of Ourselves
Rosemary Azzaro
Marketing and Communications Consultant
Creative Contributor, HBA
Although you are reading this in our first 2003 issue of the HBA Bulletin, I am writing this right before Christmas-a time of year that certainly begs the questions of "Work? Life? Balance?" It is a documented fact that women have a tendency to neglect themselves-read that, neglect their health-because they put their own needs at the bottom of the list. Let this "New Year" column be a motivation and rationale for you to put yourself first in the health department so you can succeed-at work and at home.
Most healthcare plans encourage an annual visit to the physician and gynecologist, providing them at a nominal co-pay or fully-reimbursed. For women, it is especially important to note that there are a few key chronological milestones for screenings. And, for busy women, many healthcare plans, including Oxford and Aetna, provide Internet-based tools for managing both individual and family health issues and keeping track of insurance claims. There are also other Internet services, such as "My Health Journal" offered by medcohealth (formerly Merck Medco) and "Personal Health Record" from WebMD that can help you to stay on top of your daily and long-term health plan.
To help manage your own well-being, here is some practical advice:
Be Prepared: Keep your own health history. Your primary care physician, and any specialist you see, will ask for and take a medical history. Be sure you have written down the medications you take and the dosing schedules for them. My father keeps a list of his conditions, major surgery dates, physician phone numbers and medications in his wallet. Some of the Internet tools mentioned above can help you generate this document. It is also a good idea to write down your key health concerns so that you will not get sidetracked during an exam.
Annual Physical: Check your health care benefits to see how annual check-ups are handled. Be prepared to spend some time with your doctor to cover anything new since your last check-up or visit. You should expect to have your blood pressure checked and to give a blood and urine sample for age and clinically-appropriate tests based on your personal health profile. A colon health check should be done (see "Colorectal Health")-as well as a breast exam (see "Breast Health")-although you might choose to have these done by your gynecologist.
Breast Health: Monthly breast self-examination, using touch and visual observation, is an effective tool in screening for breast cancer when performed regularly and properly. You can easily mark your calendar with a reminder. If you are uncertain about the proper way to examine your breasts, you can educate yourself by visiting InteliHealth and viewing the educational video. Or, ask your doctor to guide you at your next exam or obtain a pamphlet available from local women's health centers, the American Cancer Society or the government.
Women over 40 should get a mammogram every one to two years. This guideline was just re-issued by the federal government's US Preventive Services Task Force. And, it is also the position of the Secretary of the US Department of Health and Human Services. Additionally, the National Cancer Institute recommends that women between the ages of 40 and 49 have screening mammography every one to two years. The American Cancer Society, however, recommends mammography annually in this age range. If you are at higher risk for breast cancer, your physician may recommend you begin to get screening mammography at an earlier age.
Bone Health: Osteoporosis, like heart disease, is a "silent" thief that can steal our health without us ever realizing it. A healthy diet, exercise (especially weight bearing exercise) and calcium supplementation as recommended by your doctor are keys to maintaining good bone health. The National Osteoporosis Foundation recommends bone mineral density tests for all postmenopausal women with fractures, all women under the age of 65 with an additional risk factor for osteoporosis (such as having a small, slight frame or being a smoker), and for all women age 65 and over.
Reproductive Health: Women of all ages (starting at age 18 or at the onset of sexual activity) should have an annual pelvic exam and Pap smear. As many women have a tendency to use their OB/GYN as their primary care physician, these physicians will assess your overall state of wellness, and pay particular attention to your menstrual, pregnancy, contraception and sexual activity history and current concerns. Additionally, a breast exam will be performed and blood tests may be ordered as appropriate for age and lifestyle. Women forty and older should also have a colorectal exam including a stool sample to test for possible changes in your colon.
Annual gynecologic exams are particularly important for the detection of gynecologic cancers and "hidden" sexually-transmitted diseases such as chlamydia.
Interestingly, this past year, there were three news events related to reproductive health that, in my opinion, help make the case for annual exams for women in every age range.
In May, 2002, a controversial consumer ad campaign was sponsored by the American Society of Reproductive Medicine (ASRM) to alert women to the fact that fertility is age-related and can also be affected by lifestyle choices such as smoking. While the news seems to be filled with stories of celebrity older mothers, the fact remains that fertility takes a marked decline at age 35 and again at age 40. If you are in this age range and considering a family, younger IS better. If you are trying to conceive, over the age of 35 and have had well-timed intercourse and are not pregnant after six months, it might be time to speak with a reproductive endocrinologist. If you are younger, allow a full year to pass before seeking intervention. For more fertility-related information, visit the American Society for Reproductive Medicine.
In July, 2002, the National, Heart, Blood and Lung Institute's Women's Health Initiative (WHI) halted its study on combination hormone replacement therapy. In its most recent review of the study data, the WHI Data and Safety Monitoring Board saw an increased risk of breast cancer in women taking estrogen plus progestin compared with those taking placebo pills. The Board also saw that the previously identified risks for heart attacks, strokes and blood clots to the lungs and legs had persisted. Therefore, in the judgment of the Board, the overall risks outweighed the benefits of taking estrogen plus progestin.
While this study looked specifically at the risk-benefit ratio of estrogen/progestin combinations, it did not address the risks-benefits of estrogen therapy alone for treating symptoms of menopause. Each woman and her physician are encouraged to determine the best course of action for treating both short- and long-term symptoms and effects of menopause. Further information on this topic can be found at the Women's Health Initiavtive.
The third piece of news was released in October, 2002, when the American College of Obstetricians and Gynecologists published the results of the first study to put a cost on lost productivity by female workers related to menstrual irregularities. Based on an average 36.8-week work year, women with heavy periods work an estimated 3.6 fewer weeks per year and lose an estimated $1,692 annually in wages compared to the general female workforce. While this is eye-opening for operations managers, I think the study helps us all recognize that menstrual problems are problems and should be discussed with our physicians.
In managing our reproductive health, we should be honest with our physician related to our sexual habits and activities, our wishes for having families and open about the ways the physical changes in our bodies affect our emotions.
Cardiovascular Health: Cardiovascular disease (CVD) is the number one killer of women in the US. Women are at increased risk for heart disease at menopause and their symptoms are different from those of men with heart disease. Risk factors for women include smoking, being overweight, inactivity, family history of CVD and other medical conditions such as diabetes. Making lifestyle changes can help reduce risk. To help assess your own risk for CVD, visit the American Heart Association and link through to the Women's Page. Your heart health should be checked by your primary care provider annually via a blood pressure reading, blood tests to measure your cholesterol and triglyceride levels, and a careful history to detect any possible symptoms of early CVD. Women with risk factors or symptoms may be asked to take additional tests such as a resting electrocardiogram, an exercise stress test, an echocardiogram or a combination of the stress test with the echocardiogram.
Colorectal Health: Colorectal cancer often has no symptoms and can take from 5-15 years to develop from a precancerous polyp. Colorectal cancer is the nation's number two cancer killer, stealing the lives of more than 130,000 men and women annually. (This is not a man's disease, as is so often the misconception.) The American College of Gastroenterology recommends an annual fecal occult blood test (digital rectal exam) starting at age 50 (sooner if you are at increased risk). A flexible sigmoidoscopy is recommended every three to four years after age 50 and screening via colonoscopy is recommended for those with risk factors or suspicious findings during the other routine screenings.
Lifestyle:Your mother was right. So was your grandmother. An apple_along with four other servings of fruits and vegetables daily_helps maintain health. Exercise, regularly and in moderation, drink plenty of water, reduce stress and get your rest. For tips and support in maintaining a healthy weight, consider joining a gym with a friend or visit Weight Watchers.
While these are good places to start, there are other important health issues to monitor such as eye and ear health, skin, and oral health. Why not pay a visit to the National Women's Health Information Center to review the general health screening and immunization guidelines.
Most importantly, put yourself on your calendar and take charge of your health from self-care, to regular physician appointments and screenings.
May these skills for your health maintenance help you to enjoy a happier, healthier 2003!