Do you do self breast exams? If not do not feel ashamed there are many women that don’t. In fact the USPSTF and the ACOG no longer directly recommend monthly breast exams. Now the recommendation is breast self-awareness which focuses on having a sense of what is normal for you breasts so that you are aware of even small changes. Well what better way to be aware of your breasts than with periodic self-breast exams.
So what exactly is a self-breast exam: Check out my In The Clinic Video: Self Breast Exams.
As a pediatrician for adults vaccinations are an important part of preventive medicine. Here is the breakdown of the vaccines that are recommended by the CDC and and explanation as to which ones are needed and why.
TDAP/TD (Tetanus Diphtheria and Pertussis):
This is a vaccination that is recommended every 10 years. Usually given initially in childhood it is recommended that that the vaccine is repeated every 10 years. This vaccination protects you from 3 bacteria: 1)Clostridium tetani which causes “lock jaw” or stiffening of other muscles that can lead to breathing difficulties or even death. 2) Clostridium diphtheria which can also cause difficulty breathing difficulty, paralysis and death 3) Bordetella pertussis which can cause “whopping cough”. Pregnant women and close family members are recommended to have an update of the vaccination to protect the newborn from peruses as infants are at an increased risk for a severe course from the organism.
MMR (Measles, Mumps, and Rubella):
This vaccination is usually one that is given in childhood. If you are unsure and preparing for college physicals it’s likely colleges will want proof of vaccination or will want proof of immunization with titers. If your tigers show that you are not immune then you will need booster vaccinations.
Varicella and Shingrix:
If you were born before 1980 like myself then you may recall having the chicken pox. Those after 1980 likely received the Varicella vaccine which protects from chicken pox (also known as Varicella zoster which is a herpesvirus). Once infected zoster sits dormant in areas of our nerves where it can reactivate and cause shingles.
f you don’t recall if you’ve had the chicken pox or the vaccine, titers are a way to test if you have immunity. If you don’t have immunity then I do recommend having a conversation with your PCP about your vaccination options.
HPV Vaccine (Human Papilloma Virus):
Human Papilloma Virus has thousands of subtypes. There are several subtypes that are associated with 6 types of cancer: cervical, anal, oral, penile, vaginal, and vulvar cancer. The HPV vaccine ideally is given between 11-26 however can be given up to age 45.
Hepatitis A&B Vaccine:
Hepatitis A and Hepatitis B are the only hepatitis vaccinations that can be vaccinated against. Hepatitis A usually causes a minor self-limited illness and patients usually recover easily without any damage to their liver. Hepatitis B however can develop into a chronic infection and lead to liver cancer, liver failure, or worse.
If you are not sure if you have been immunized, ask your provider to check your lab work for confirmation.
Usually give. In childhood often boosters of the meningococcal vaccine are indicated for those at high risk for meningitis. Examples are those going off to college, those who have sickle cell disease, those whose spleen have been removed, etc.
Usually this is not considered a standard or routine vaccinations for those who have left their college days behind.
Pneumococcal Vaccine (Prevnar and Pneumovax):
Patients with asthma, COPD, interstitial lung disease, HIV, diabetes mellitus, chronic heart disease, chronic liver disease, and smokers should be considered for this vaccine.
A lot of people think that the pneumonia vaccine stops you from getting pneumonia but it actually protects you from some variations of the bacteria Streptococcus pneumoniae that can cause serious invasive infections that are severe and life threatening.
Haemophillus Influenza B:
Individuals who have medical illnesses like HIV, sickle cell, asplenia, cancer requiring chemotherapy, radiation therapy, or bone marrow transplant, or complement deficiency syndromes.
This vaccine is one that is recommended yearly. While many people feel that the vaccine is not necessary or feel that they get sick after the vaccine I recommend given the current pandemic that you reconsider and talk with your provider.
For more of my thoughts about this vaccine or any of the others check out my video “Adult Vaccinations” on YouTube.
What is a P.C.P.?
Why you should have a P.C.P.
Using the car metaphor the best time to know a mechanic is not when something is wrong with your car but before. When you have one car you want to take your vehicle to someone that you trust, someone that you know, and someone who knows just how important your one vehicle is to you. In my life I try to be proactive as much as possible vs reactive. When you check engine light is on and the car is making a clunking sound and stalling periodically you don't want to go interviewing mechanics to fix the problem. You want to know exactly who to go to and what to expect. The same can be said for your health.
I recommend that you consider getting a provider if you don't have one. If you haven't seen your provider in >1 year now's the time to reconnect. My healthiest patient's are always encouraged to follow up with me yearly. If they are still healthy it's a quick visit to just make sure they are on track. Your yearly physical is really a time for us providers to make sure everything is going okay with you routine wise. It is not the time to bring up everything that you have felt throughout the course of the year--that's what a sick visit is for.
Sick visits are visits you make to your provider to discuss problems that you have been experiencing to determine what needs to be done to address them if anything at all.
Follow up visits are visits to follow up on chronic medical issues if you have any such as diabetes, hypertension, high cholesterol, hypothyroidism, etc that need periodic monitoring to make sure that your chronic medical issues are stable and well managed.
But I digress...the key take away point here is that having someone that you know and trust before a problem possibly arises is always better than meeting someone in the midst of an ongoing problem. So take a proactive tip from a proactive person (most times) and get a PCP if you don't already have one.
How to find a PCP.
I try to tell all my patients when they first meet me that I may not be their cup of tea. Not every provider is the same and not every provider will fit for every patient. I am FAR from perfect. As a provider my goal is that you find a physician you feel comfortable with to establish a longterm relationship with. If it's not me but someone else in my practice that's fine. I'll still say "Hi" and treat you with respect if you leave my practice because my hope for everyone is the best care for them.
I say this to say that if you don't like one provider at a practice that doesn't mean that the other providers are off limits. Shop around you might find someone else there that you to mesh with.
Another way to find a PCP is to let your fingers and google do the walking. This is a risky move because there are some great providers with some lousy scores (stars) all because patient's who are satisfied and happy do not think to write good reviews. Its just like at restaurants--ask a manager if they hear more complaints or compliments about their food, service, or establishment and you are likely to find they hear more complaints which is why I always (before COVID) makes sure when I receive excellent service to ask for a manager. I feel back for the server because they tend to panic a bit but I always try to assure them that its a good thing but it still puts them on edge until after I speak with the manager who confirms that I was only complementary. I digress again...(I do that a lot)...using Google for reviews can be helpful but beware that if you see bad reviews read what the comments were and what the problem was--staffing issues don't necessarily reflect on the providers ability or bedside manner. So keep that in mind.
Another resource is your insurance company to see who is in network. Starting their coupled with an on-line search is a resource that saves the hassle of finding out too late that a provider is not covered by your insurance. Don't forget you can "interview" providers. Yes you will be "doctor shopping" and yes you will have to fill out a lot of forms over and over again, and yes there will be a copay likely but it is a way to meet a provider in person and get a feel for their style of practice and bedside manner.
What is Coronavirus or COVID-19?
How does it spread?
While a lot is being learned about this new virus what we do know at this time is that it is spread via droplets found in the air after someone sneezes or coughs. Droplet spread does not spread far in the air however because of its weight will fall onto surfaces or the ground within seconds.
What are symptoms?
How is COVID-19 diagnosed?
What are the treatment options?
Despite what you here there is no treatment for COVID-19 at this time. NONE! I stress this because there are many reports regarding possible usage of medications such as Hydroxychloroquine and Azithromycin however neither of these drugs has been proven to be effective in treatment of this illness and the risks of these medications used together or even alone include arrhythmia, blurred or loss of vision which can be permanent, heart failure, angioedema—swelling of the skin. I stress no matter what you hear the FDA has not approved either drug for treatment in COVID-19 cases.
How deadly is the infection?
Should I be tested?
According to the CDC not everyone needs to be tested for COVID-19. The CDC has specific guidance for patients as well as providers on who should be tested.
If you aren’t sure talk with you primary care provider about your symptoms and discuss if testing is necessary.
What to do if I think I have COVID-19?
If you were not tested but suspected that you were positive and as a result self-quarantine the guidelines are you can end your quarantine if you have not had a fever for 72+ hours (without the use of medication) AND your symptoms have improved AND 7 days have passed since your symptoms first started.
Where can I get more information?
The CDC website is a very reputable source and the best (in my opinion) source for information so start there. Another source to use if your primary care provider. If you have questions schedule a virtual visit or telephone visit with your primary care provider to discuss symptoms or concerns. As providers part of our job includes education.
In the end remember we are all in this together! We will get through this together by being well informed, cautious, and patient.
Clinic moves at a fast pace. Every month my goal is to feature a topic that came up during my clinic or to discuss health topics that you are concerned about.
Disclaimer: I am a physician, but I am not your physician. The information on this website is for general informational purposes only and is not meant to substitute for medical advice. This website does not create an physician-patient relationship. The author is not liable for any illnesses, losses or damages related to actions of failure to act related to the content in this website. If you need specific medical advice, consult with your healthcare provider.